TagJAMA

Reading of the Week: Antidepressants after Acute Coronary Syndrome and Depression – A Lifesaver? The New JAMA Paper

From the Editor

State-of-the-art care for acute coronary syndrome includes oxygen and clot-busting drugs. Should it also include a depression screen and an antidepressant if necessary?

In this week’s Reading, we look at a new JAMA paper showing a response to escitalopram for patients post-ACS (Acute Coronary Syndrome) with depression. Though work has been done in this area before, this paper is an important contribution: it’s well designed, and offers a long follow-up period. Chonnam National University Medical School’s Jae-Min Kim and his co-authors conclude: “In this median 8.1-year follow-up of a randomized 24-week clinical trial of treatment for depression in patients with recent ACS, MACE [major adverse cardiac event] incidence was significantly lower in patients receiving escitalopram than those receiving placebo.”

We consider the paper and its implications.

norm_2xGood EKG, good antidepressant?

Please note that there will be no Readings for the next two weeks.

DG
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Reading of the Week: Rahael Gupta on Medical Students & Depression (& her Depression)

From the Editor

Once—and I have never shared this before—I stepped into the street on my walk home from the library. I knew that the bus hurtling through the night would not have time to stop before colliding with my darkly dressed frame, fracturing my bones and scattering my belongings. I imagined my head hitting the asphalt and my brain banging around inside of my skull, bruising irreparably with each impact. I imagined the bus driver’s horror as he turned off the ignition with shaking hands and leapt out of the vehicle to locate my body. It would be a catastrophe that the trauma surgeons could not salvage. I would die.

Rahael Gupta is many things. She’s a graduate of Stanford University, and also Columbia. She’s a medical student. She’s a self-described optimistic. She’s a marathon runner.

And she’s a person who has struggled with depression.

michigan-med-l-med-student-depression-keyvisual

In this week’s Reading, we consider her essay in JAMA. It’s moving and clever and important.

DG

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Reading of the Week: “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA on Psychotherapy

From the Editor

Is CBT overrated? The authors of a new JAMA paper raise this question in a cutting Viewpoint.

In this two-part Reading of the Week series, we look at two papers, both published in JAMA. These Viewpoint pieces make interesting, provocative arguments.

Last week, we looked at conversational agents.

This week, we ask: is CBT really the gold standard for psychotherapy?

University of Giessen’s Falk Leichsenring and Medical School Berlin’s Christiane Steinert consider CBT and the research that has been done in the area. “CBT is usually considered the gold standard for the psychotherapeutic treatment of many or even most mental disorders.” But should it be? Leichsenring and Steinert argue no.

beck_aaron_t-_112798Aaron Beck: Great bowtie, but is his CBT really so great?

In this Reading, we review their paper, and consider their argument.

DG

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Reading of the Week: “Talking to Machines About Personal Mental Health Problems.” JAMA on Therapy & AI

From the Editor

Will people seek therapy with computers one day, getting care from programs built with Artificial Intelligence?

The authors of a new JAMA paper consider this in a short, clever piece, titled “Talking to Machines About Personal Mental Health Problems.”

In this two-part Reading of the Week series, we look at two papers, both published in JAMA. These Viewpoint pieces make interesting, provocative arguments.

This week, we look at conversational agents.

Next week, we ask: is CBT really the gold standard for psychotherapy?

Stanford University’s Adam S. Miner and his co-authors consider conversational agents – that is software programs that “use conversational artificial intelligence to interact with users through voice or text.” Could there be therapeutic value in such a program? What are the ethical challenges?

Robot and human hands almost touching - 3D render. A modern take on the famous Michelangelo painting in the Sistine Chapel; titled, "The Creation of Adam".

In this Reading, we review the paper, and consider the potential of conversational agents, with an eye on what’s currently available.

DG

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Reading of the Week: To Screen or Not to Screen – Pregnancy & Depression Screening

From the Editor

“Panel Calls for Depression Screenings During and After Pregnancy”

A government health-care panel making a revision to a past recommendation seems pretty ‘inside baseball’ – and hardly the stuff of international headlines. Last week, though, the decision of the U.S. Preventive Services Task Force to now recommend the screening of pregnant and post-partum women for depression was reported from New York to New Delhi.

For the record, The New York Times story (whose headline appears above) ran on the front page.

Why the change and what are the implications?

To screen or not to screen…

This week’s Reading looks at the big decision and we consider: is it a big bust?

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Reading of the Week: Physician, Heal Thyself: Residents and Depression, and More

From the Editor

This week – like last week – we pick a few interesting readings to consider.

This week’s selections: a chef and his addiction, a major new JAMA paper on resident physicians and depressive symptoms, and a big paper from BMJ comparing CBT and meds for depression.

Next week: the best of the year (the annual tradition). Suggestions are welcome for the best papers of 2015.

DG

Selection 1

“Three years after his mysterious disappearance, former Langdon Hall chef breaks his silence”

Mark Schatzker, The Globe and Mail, 1 December 2015

On the night of Dec. 28, 2012, Jonathan Gushue, one of Canada’s most decorated chefs, disappeared. He finished a dinner service at Langdon Hall that included pickerel in crème fraîche with black radish and black-pepper honey, got into his car and never arrived home.

No one, including Gushue’s wife, his sous chefs and his friends, knew what had happened to the 41-year-old father of three who, just two years earlier, had put Langdon Hall, in Cambridge, Ont., on the prestigious San Pellegrino World’s Best Restaurants list. As the chef’s disappearance made headlines from coast to coast, mysterious details began leaking out – his phone was found at an upscale Toronto hotel – but nothing more.

Thirteen days later, Gushue was found and reported safe. Several months later, he left Langdon Hall, then vanished from public life.

Jonathan Gushue

Gushue had it all – a young family and a soaring career. He also had alcoholism. Continue reading

Reading of the Week: Ending Chronic Homelessness

Can we end chronic homelessness?

Just a few years ago, that question would have seemed absurd. Chronic homelessness was, well, chronic. Today, a re-think of an old problem is yielding incredible results. And here’s the best part: Canadian researchers and the Mental Health Commission of Canada are playing crucial roles.

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