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1.  Unacceptable status quo in access to mental health care 
PMCID: PMC2802627  PMID: 20064971
2.  Prevalence of Psychiatric Disorders Among Toronto Hospital Workers One to Two Years After the SARS Outbreak 
This study aimed to determine the incidence of psychiatric disorders among health care workers in Toronto in the one- to two-year period after the 2003 outbreak of severe acute respiratory syndrome (SARS) and to test predicted risk factors.
New-onset episodes of psychiatric disorders were assessed among 139 health care workers by using the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale. Past history of psychiatric illness, years of health care experience, and the perception of adequate training and support were tested as predictors of the incidence of new-onset episodes psychiatric disorders after the SARS outbreak.
The lifetime prevalence of any depressive, anxiety, or substance use diagnosis was 30%. Only one health care worker who identified the SARS experience as a traumatic event was diagnosed as having PTSD. New episodes of psychiatric disorders occurred among seven health care workers (5%). New episodes of psychiatric disorders were directly associated with a history of having a psychiatric disorder before the SARS outbreak (p=.02) and inversely associated with years of health care experience (p=.03) and the perceived adequacy of training and support (p=.03).
Incidence of new episodes of psychiatric disorders after the SARS outbreak were similar to or lower than community incidence rates, which may indicate the resilience of health care workers who continued to work in hospitals one to two years after the SARS outbreak. In preparation for future events, such as pandemic influenza, training and support may bolster the resilience of health care workers who are at higher risk by virtue of their psychiatric history and fewer years of health care experience.
PMCID: PMC2923654  PMID: 18182545 CAMSID: cams1445
4.  Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak 
Emerging Infectious Diseases  2006;12(12):1924-1932.
TOC Summary Line: Healthcare workers in hospitals affected by SARS experience increased psychological stress 1–2 years after the outbreak.
Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes. Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001). Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress. Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors. The results reinforce the value of effective staff support and training in preparation for future outbreaks.
PMCID: PMC3291360  PMID: 17326946
Severe Acute Respiratory Syndrome; Stress, Psychological; Health Personnel; Stress, Traumatic; Burnout, Professional, research
5.  Meeting mania 2004 
BMJ : British Medical Journal  2004;329(7480):1467-1469.
The rise in the number of meetings occurring every day in healthcare institutions shows no sign of abating. What are the factors contributing to this “meeting mania,” and is there anything that can be done to counter it?
PMCID: PMC535983  PMID: 15604186
6.  Tunnelling to 50: an exploratory medical memoir 
PMCID: PMC534587  PMID: 15583192
9.  Bulimia Nervosa  
Since the delineation of bulimia nervosa as a distinct syndrome in 1979, a variety of etiological models and related treatments have evolved. Methodological advances in evaluation have been reflected in recent outcome studies. There is now extensive evidence for the effectiveness of various short-term psychotherapies for bulimia nervosa. However, there is no convincing support for the specificity of any one form; all have a salubrious effect. Cognitive-behavioral therapy has been the most extensively researched. A parallel literature examines antidepressant pharmacotherapy for this disorder, and there are recent studies of comparative and integrative aspects of drug therapy and psychotherapy. Issues related to the long-term outcome of short-term interventions, predictors of response, and mechanisms of change await elucidation.
PMCID: PMC3330317  PMID: 22700125

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