Tagdepression

Reading of the Week: Mood & Anxiety in Four Countries – More Care, Better Outcomes? The Jorm et al. Paper

From the Editor

Earlier this month, the Commonwealth Fund released a report that surveyed 11 countries for the performance of their health-care systems; it received much media attention. Their work helps provide perspective on our system’s strengths and weaknesses.

International comparisons are relevant in mental health, of course. As stigma fades and as evidence-based treatment options have expanded, we can ask: are people with common mental health problems getting better? And are there lessons to learn from our national experiences?

Four countries, one big problem?

This week, we look at a study that has just been published in World Psychiatry, drawing data from four countries. In the paper, Jorm et al. find that – looking at the prevalence of mood and anxiety disorders and symptoms – people aren’t better off today. The authors consider several explanations.

This paper hasn’t gather much attention here in Canada. But as we look to increase funding for mental health services, it’s an important and relevant paper.

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Reading of the Week: Can We Predict Relapse in Depression? The Judd et al. Paper from The American Journal of Psychiatry

From the Editor

Is he going to get sick again?

It’s a question that we often ask when a patient overcomes depression and happily leaves our office. For many patients, depression is a chronic illness – and so, remission is followed by relapse. Is it possible to predict patients with depression who are in remission but at risk of relapse?

Can we predict a future relapse – or is this an exercise in fortune-telling?

This week’s Reading is a paper from The American Journal of Psychiatry. Drawing on a long-term study, they look at the pattern of acute illness, remission, and relapse. Using statistical analyses, the authors seek to find a way of predicting relapse.

Spoiler alert: they do.

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Reading of the Week: The New CANMAT Guidelines for Depression

From the Editor

What’s new in depression treatment?

The new guidelines

This week, we look at the new CANMAT guidelines. Published in September in The Canadian Journal of Psychiatry, the papers – six in all – speak to the latest in depression management.

What should you think about the new antidepressants? What alternatives are there to CBT? What to do when everything else fails? Spoiler alert: this week’s Reading answers all these questions and more.

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Reading of the Week: What’s New in Psychotherapy – The Cuijpers et al. Paper

From the Editor

What’s new in psychotherapy?

If there is one area of psychiatry that seems to have been transformed in recent years, it’s psychotherapy. Not surprisingly, then, past Readings have looked at the expanded role of short-term, evidenced-based therapies – in particular, Cognitive Behavioural Therapy, or CBT.

Today’s psychotherapy: a long way from Freud

Over the next two weeks, we’ll look in more detail at new developments in psychotherapy.

This week. A major new review of IPT.

Next week. An overview of psychotherapy developments.

This week, we consider a new paper published in The American Journal of Psychiatry on Interpersonal Therapy, or IPT. This paper is clear, lucid, and worth reading.

Is there evidence for IPT? Yes – and more than just for depression.

DG Continue reading

Reading of the Week: Do Cities Make Us Sick?

From the Editor

Do cities make us sick?

It’s a question people have been asking for years with many advocating that we should – to steal a line from Huckleberry Finn – get the lights fantastic out of town.

Big city, big mental illness?

This week, we look at a new paper just published in The Canadian Journal of Psychiatry that looks at urban vs. rural populations and depression.

Then, turning to The Atlantic, we consider an essay written by a psychologist that looks at the connection between psychosis and cities.

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On The Night Table: The New Depression Guidelines

On the night table…

“Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder”

The CANMAT group’s latest work is published in The Canadian Journal of Psychiatry.

The full documents are now online first.

Find them here:

http://cpa.sagepub.com/content/early/recent

My sense after a first read? Excellent and practical.

Reading of the Week: Do the Meds Work? Peter Kramer’s Essay, and More

From the Editor

Do the pills really work?

It’s a question that we clinicians are repeatedly asked. Antidepressants are widely prescribed, but often doubted – by our patients and by people in general.

This week, we look at an essay penned by Dr. Peter Kramer, an American psychiatrist. Dr. Kramer, you may recall, made a name for himself two decades ago by extolling the super-therapeutic powers of Prozac. Today, he has a more modest goal: explaining the role of antidepressants in the treatment of depression.

Then, looking to The New England Journal of Medicine, we consider a paper that discusses the rise and, perhaps, fall of randomized controlled trials as the “gold standard” of medical research.

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Reading of the Week: Battling The Black Dog

From the Editor

This week, hundreds of thousands of Canadians will not go to work because of mental health problems, depression being the most common.

But despite the long shadow cast by depression on our society, it’s difficult not to feel that we fall short in terms of our active management. Many people struggle with their symptoms; even when they can beat the “black dog” – to use Winston Churchill’s term – they are at high risk for relapse.

Can we do better with the black dog?

Here are two papers that look at bettering outcomes.

In the first, the authors ask if mindfulness can prevent the relapse of depression. The second paper considers the use of statins to improve the effects of antidepressants.

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Reading of the Week: Thinking Globally and Acting Locally – Scaling Up Depression and Anxiety Treatment

From the Editor

Tim Evans doesn’t mince his words: “The situation with mental health today is like HIV-AIDS two decades ago.”

Tim Evans is a senior director at the World Bank Group. He made these comments after the release of a major new study suggesting that depression and anxiety are undertreated – and costing the world’s economy hundreds of billions of dollars a year.

But this paper has good news: an investment in mental health services will offer a return (counting health benefits) in the range of 3.3 to 5.7.

This week’s Reading: this new paper from The Lancet Psychiatry, and the reaction to it. Note that coverage has included The Guardian and The New York Times (Evans comments are from The New York Times).

I also follow up on last week’s popular Reading on the Goldbloom-Bryden book.

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Reading of the Week: How Successful Are We at Treating Canadians with Depression? And More

From the Editor

How successful are we at treating Canadians with depression? How could Canada’s health care system serve these patients better?

This is the ‘all Canadian’ issue of the Reading of the Week.

Readings don’t necessarily follow a theme – but we do this week. The two papers are written by Canadian authors; they tackle Canadian topics; they were published in a Canadian journal, The Canadian Journal of Psychiatry.

The first paper considers depression in Canada, looking at prevalence and treatment over a decade. The second paper champions more effective care for Canadians. Both are readable and relevant.

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