TagHayes

Reading of the Week: Mental Health Care – Doing Bad, Feeling Good? The Hayes et al. Study

From the Editor

Greetings from Ottawa. This morning, the Canadian Psychiatric Association’s 67th Annual Conference opens here. And the agenda looks great, and includes the release of the new Canadian guidelines for the treatment of schizophrenia.

It’s difficult not to feel upbeat, as people from coast to coast to coast gather to discuss new findings and new ideas on problems like refractory depression and chronic pain and, yes, schizophrenia. And this is a great time to be involved in mental health care – as stigma fades and societal recognition grows.

But how are we doing in terms of actual outcomes? This week, we look at a new British Journal of Psychiatry paper. Hayes et al. consider mortality for those with severe mental illness and the rest of us. Unfortunately, the authors find that the mortality gap has grown with time.

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Ottawa: Host city of this year’s CPA Annual Conference

In this Reading, we review the paper and an editorial, and consider the larger context.

DG

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Reading of the Week: Guest Contribution – Dr. David Goldbloom on Lithium and Self Harm

From a Contributing Editor, Colleague and Friend of the Editor

Sixty-seven years ago, Australian psychiatrist John Cade published his case series on manic patients treated with lithium – truly the dawn of the modern era in psychopharmacology. Two decades passed before lithium came to Canada, and almost three before it came to the United States. In the treatment of mania, it was the first significant drug alternative to the only other enduring treatment from that time – electroconvulsive therapy.

Dr. John Cade (and Lithium)

Today, however, lithium suffers from under-promotion (there is no money to be made on it by the pharmaceutical industry) and under-exposure in the training of residents despite the evidence of its benefit that continues to emerge.

Here is a new paper that looks at suicide and self-harm during maintenance treatment of people with bipolar disorder treated with lithium, valproate or the increasingly popular second-generation antipsychotic drugs. And here is an old paper that reminds us what a difference lithium had already made in the economics of mental illness by 1980.

– David Goldbloom, OC, MD, FRCP(C) Continue reading