TagFinland

Reading of the Week: Is Lithium Underrated? Preventing Rehospitalization with Bipolar – the New JAMA Psychiatry Paper

From the Editor

From the perspective of the treatment team, a rehospitalization is a failure – a patient returning to the system, unwell again. From the perspective of the patient and her or his family, a rehospitalization can be frightening and humiliating.

How best to keep people with bipolar affective disorder out of hospital? In a new JAMA Psychiatry paper, the University of Eastern Finland’s Markku Lähteenvuo and his co-authors attempt to answer this question – not by using a RCT, but instead by tapping Finnish national databases.

For the record, they find one medication works better than the others: lithium.

800px-central_hospital_of_central_finlandFinland’s Central Hospital: adequate architecture but good data

In this Reading, we consider the new paper by Lähteenvuo et al., and also consider their approach.

DG

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Reading of the Week: Is ‘New’ Overrated? Antipsychotics in the Real World

From the Editor

Is new better?

You may be reading this on an iPhone 7, having driven to work this morning in a 2017 Hybrid Prius. So should your patients be taking a medication that became available four-and-a-half decades ago – when people drove gus-gusling eight-cylinder Oldsmobiles and smartphones didn’t even exist in science fiction novels.

This week, we look at a just-published JAMA Psychiatry paper which promises to look at the “real-world” effectiveness of antipsychotics. The authors tapped Swedish databases to consider outcomes for nearly thirty thousand people with schizophrenia.

Sweden: elaborate welfare state, beautiful historic buildings, and – yes – rich databases

Spoiler alert: new wasn’t better. That is, newer antipsychotics tended to underperform clozapine and depot medications.

We also look at similar “real-world” work drawing from a Finnish database considering treatment of depression.

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Reading of the Week: Technology & Mental Health – Depression and Internet-based CBT; Also, Finnish e-Therapy

From the Editor

VR. e-therapies.

New technology is changing the way we think about the delivery of psychiatric services. But new isn’t necessarily better. Can care really be transformed? What does the literature say?computere-therapy: more than clever pictures of computers and stethoscopes?

In a two-part Reading of the Week, we look at technology and psychiatry.

Last week, Virtual Reality.

This week, e-therapies.

This week, we consider a new paper that has just been published. Its looks at self-guided Internet-based CBT showing that for every eight people treated, one benefits (consider this in the context of minimal cost).

And, in the other selection, we look at the Finnish experience with Internet-based CBT.

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