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Reading of the Week: PTSD & Treatment – What’s Evidence Based? JAMA Psychiatry’s New Network Meta-analysis

From the Editor

Just over a century ago, Dr. Charles Myers wrote “A Contribution To The Study Of Shell Shock” in The Lancet, the first paper on shell shock. Today, our understanding of PTSD has greatly evolved.

But what’s the most effective treatment for people with PTSD?

This week, we consider the new paper by the University of Basel’s Jasmin Merz and her co-authors. They use a network meta-analysis to determine whether patients do better with medications, psychotherapy, or both; in other words, they attempt to analyze different studies in this area, but not necessarily those that do direct comparisons (that’s my Twitter-length biostatistical summary). They find: “The available evidence is sparse and appears not to support the use of pharmacological therapy as first-line treatment for posttraumatic stress disorder…”

ptsd

We also consider an editorial that runs with the study. Murray B. Stein and Sonya B. Norman, both of University of California San Diego, are critical, commenting that aspects of the study may be “hard to swallow.”

DG

 

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Reading of the Week: Can Social Connectedness Prevent Suicides? The New JAMA Psychiatry Paper on Caring Contacts in the Military

From the Editor

Social disconnectedness contributes to suicide. Past studies have tried to connect with people at risk, using simple tools like postcards.

This week, we look at a JAMA Psychiatry paper. The University of Washington’s Katherine Anne Comtois and her co-authors use a text message-based intervention (Caring Contacts) to try to reduce suicidal thoughts and behaviours in active military personal. They find: “Although the primary hypotheses were not supported, Caring Contacts was found to be a simple, scalable intervention that may be effective in reducing the occurrence of suicide ideation and attempts.”

Military man texts using smart phone in the city Suicide prevention by text: clever? Too clever?

We consider the paper and two editorials. We also consider a New York Times essay that asks: “If suicide is preventable, why are so many people dying from it?”

DG

 

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