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Reading of the Week: Cutting-Edge Care – Esketamine for Depression (NEJM), Digital Psychiatry for Suicide Prevention (JAMA Psych), Asylums for All (AJP)

From the Editor

This time of year, many doctors take to social media to offer advice to young colleagues as they start their specialty training (#TipsForNewDocs). Generally, the tweets give solid suggestions on everything from the importance of mentorship to doing regular exercise. For those new grads beginning psychiatry training, I offer: read more, the field is evolving. Since I started my psychiatry residency 19 years ago this month, we have seen new antidepressants placed into the drug cabinets of our patients, mental-health apps populate their smart phones, and clinical guidelines enter our practices, helping us better manage their mental illness.

This week’s Reading focuses on cutting-edge care, and there is plenty to read.

In our first selection, we consider a new paper from The New England Journal of Medicine. Written by Dr. Jean Kim and four other FDA officials, the authors discuss esketamine for depression. “The drug represents an important addition to the treatment options for patients with treatment-resistant depression.”

nasal-spray-sEsketamine: from club drug to depression care

In our second selection, Dr. John Torous (of Harvard Medical School) and Rheeda Walker (of the University of Houston) consider digital psychiatry and suicide prevention, reviewing the field with cautious optimism. The paper opens with a single sentence that puts these efforts in perspective: “Because the rates of suicide attempts and deaths have recently increased to 50-year highs,new solutions are needed.”

And, in our third selection, we look at a not-so-new editorial from The American Journal of Insanity that calls for better treatment of the poor.

Enjoy.

DG

 

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Reading of the Week: How to Think about Practice Today – And Tomorrow? A New CJP Paper, a Podcast, and a Report

From the Editor

How do we practice today – and how will we practice in the future?

This week’s Reading includes three selections.

In the first selection, we consider how we practice today, with a new paper by University of Ontario Institute of Technology’s David Rudoler and his co-authors. Drawing on administrative data, they look for practice patterns, finding three distinct ones. Spoiler alert: practice patterns are very different, with 30% of psychiatrists seeing just two or fewer patients per month.

Then, we look ahead. In the second selection, we consider a new podcast discussing digital psychiatry. I talk with Dr. John Torous of the Harvard-affiliated Beth Israel Deaconess Medical Center. And, yes, he has tips on good apps for your patients.

Finally, in the third selection, we consider the recent Ontario government report on ending hallway medicine. The authors look to the future, and make several suggestions, including embracing the potential of digital health care.

messaging-appsApps – the future?

Enjoy.

DG

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Reading of the Week: “Your Smartphone Will See You Now” – Torous on Digital Psychiatry; Also, the Costs of Homelessness

From the Editor

A few weeks ago, a patient’s daughter called. She was deeply concerned: the patient was acting differently, she explained. “He’s sick again.” She noted that he was starting to go on long walks at night, and to different neighbourhoods – something he does when he’s starting to get ill with his bipolar. She feared that, without a change in medications and careful follow up, he would end up in the hospital again. As a psychiatrist, that type of information can be invaluable – a clue that a patient is doing less well.

Could technology help us find clues for emerging illness, maybe even before family members or patients themselves?

This week, the first selection weighs this question. Harvard University’s Dr. John Torous considers big data and mental health. In his essay, “Your Smartphone Will See You Now,” he reviews current trends and writes: “I predict that this technology will have an enormous impact on psychiatry.”

mjkxndi1nwClever cover – promising future?

In the second selection, we consider a new paper that looks at the costs of homelessness in Canada. As part of the work of At Home/Chez Soi, the authors answer a basic and important question: what are the costs of homelessness?

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

DG

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