Antipsychotic-induced weight gain has emerged as a serious complication in the treatment of patients with most antipsychotics. We have conducted the first in-depth examination of dopamine receptor genes in antipsychotic-induced weight gain. A total of 206 patients (139 of European descent and 56 African Americans) who underwent treatment for chronic schizophrenia or schizoaffective disorder were evaluated after on average over 6 weeks of treatment. Thirty-six tag single nucleotide polymorphisms (SNPs) and one variable-number tandem repeat, spanning the five dopamine receptor genes (DRD1-DRD5) were analyzed. In the total sample, we found a nominally significant association between the DRD2 rs1079598 marker and weight change using a cutoff of 7% gain (P=0.03). When stratifying the sample according to ethnicity and antipsychotics with highest risk for weight gain, we found significant associations in three DRD2 SNPs: rs6277 (C957T), rs1079598 and rs1800497 (TaqIA). The other genes were primarily negative. We provide evidence that dopamine receptor DRD2 gene variants might be associated with antipsychotic-induced weight gain in chronic schizophrenia patients.
In 2014, Stephen Harper's Conservative government introduced the Not Criminally Responsible Reform Act. Amongst the handful of changes instituted by the legislation, the Act created the "high-risk accused" designation that, when applied, heightens measures in the detention of the accused and transfers authority for their release from provincial review boards to criminal courts. While the new laws reflect the Harper government's "tough on crime" policy, I start by noting how difficult it is to sum up my gratitude to everyone that helped me with this dissertation. To my supervisor, Dr. Dawn Moore, thank you for the years of kind and patient guidance; somehow you managed to lead without stifling. Dr. Diana Young, thank you for the many concise insights you provided along the way; you always had a way of getting at what I struggled to say. Dr. Jennifer Kilty, your conscientious and thoughtful consideration was unwavering throughout this process; I was consistently awed by your attention to my drafts and your incisive comments. This has been an uncomfortably self-centred process, one in which I've had to rely on the generosity of a number of individuals for which I could offer little in return. Dr. Bruce Arrigo and Dr. Josh Greenberg, thank you for the care and work you put into the examination of this thesis. Your efforts benefitted my own understanding of this project and made an angst-ridden day more enjoyable than I initially thought possible. Andrew Squires, you were of immense support throughout these years. Aside from the obvious administrative help, I always thoroughly enjoyed our chance discussions. Siobhan MacLean, thank you for your indispensable help in the final stages of this process -your care and concern was evident. And to the late Barb Higgins, thank you for your support; it was always a pleasure when our paths crossed.The historical nature of the project has meant that people at various libraries and archives have played an essential role. John Court, you not only were incredibly thorough in helping me with my particular needs (you took on my own questions like they were your own), but you were also so gracious in involving me in the process wherever possible (even where I may have only served to complicate it). Thank you to Paul Leatherdale as well. While so much archival material was inaccessible amidst a global pandemic, you went above and beyond to provide me access to the resources I needed.To my folks, who are nothing if not supportive, thank you for the seemingly bottomless well of encouragement and understanding that extends beyond this dissertation. Waylon, I couldn't ask for a better best friend. And finally, Sarah, this simply would not have been done without you. From your active support to just letting me be so self-involved over these years, I hope you realize how important you are in my life.
Abstract. In 1954, the Canadian government established the Royal Commission on the Law of Insanity as a Defence in Criminal Cases. While its final report had little impact at the time, the creation of the commission points to the emergence of insanity as a newly complex problem within the context of postwar Canada. Spurred on by the growing psychiatric profession and the destabilization of capital punishment as a viable sentence, the commission quickly realized that the building blocks of its solution – legal and psychiatric expertise – were largely incompatible. This article explores the commission’s problematization of insanity, which, far from providing solutions, highlighted the difficulties surrounding the integration of both psychiatric and legal knowledges of the day. The commission played an important role in upholding the status quo, and it provides an early example of the stasis that would characterize this area of the law until the early 1990s.
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