Reading of the Week: AI Scribes in Primary Care – the New JAMA Psych Paper; Also, Antidepressant Prescribing and the Life & Death of Carol Sauer

February 5, 2026 / / 0 Comments

From the Editor

More physicians are turning to AI scribes to free up time. But what is the impact on clinical care?

In a new JAMA Psychiatry paper, Victor M. Castro (of Harvard University) and his co-authors attempt to answer that question by looking at scribes in primary care. In a cohort study drawing on more than 20 000 routine annual visits, they compared documentation and management of neuropsychiatric symptoms. “Incorporation of AI ambient scribes in primary care was associated with greater levels of neuropsychiatric symptom documentation but lesser likelihood of documented management of psychiatric symptoms.” We consider the paper and its implications.

In the second selection, a letter published in The Canadian Journal of Psychiatry, Dionzie Ong (of the University of British Columbia) and her co-authors consider antidepressant prescribing and evidence, focusing on citalopram and escitalopram. “Preferential prescribing of escitalopram and claims of superiority are not supported by science.”

Finally, in the third selection, Washington Post reporter Dana Hedgpeth writes about the life and death of Carol Sauer, who spent years experiencing homelessness. She had graduated from high school, attended university, and held jobs until 2000, when she became ill. A person who read her death notice on social media comments: “I cried thinking about her. This beautiful woman sitting for 20 years at a bus stop and nobody could make a difference… It’s a reminder of the power and responsibility we have to help those who are homeless and mentally ill.” 

DG

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Reading of the Week: Yoga for Opioid Withdrawal? The New JAMA Psych Paper; Also, MAOIs & History, and AI-Associated Psychosis

January 29, 2026 / / 0 Comments

From the Editor

Yoga is increasingly recognized as having a role in the treatment of those with mood and anxiety problems. But what about substance misuse?

In the first selection, from JAMA Psychiatry, Suddala Goutham (of the National Institute of Mental Health and Neurosciences, Bengaluru, India) and his co-authors attempt to answer that question in a new, early-stage randomized clinical trial. In the study, 59 men were randomized to yoga and buprenorphine or buprenorphine alone. “Those receiving yoga alongside standard buprenorphine treatment achieved withdrawal stabilization 4.4 times faster than controls (median, 5 vs 9 days) and showed significant improvements in heart rate variability, anxiety, sleep, and pain measures.” We consider the study and its implications.

In the second selection, from The Journal of Clinical Psychiatry, Vincent Van den Eynde (of Radboud University) and his co-authors write about the MAOI class of antidepressants. In a commentary paper, they argue that these medications are underappreciated. “We thus emphasize the need for renewed attention to the classic MAOIs in clinical practice and research.”

And in the third selection, Dr. Joseph M. Pierre (of the University of California, San Francisco) and his co-authors write about AI-associated psychosis for Innovations in Clinical Neuroscience. They discuss what they suggest is the first journal-published case report, detailing the struggles of a practicing medical professional. “Although multiple pre-existing risk factors may be associated with psychosis proneness, the sycophancy of AI chatbots together with AI chatbot immersion and deification on the part of users may represent particular red flags for the emergence of AI-associated psychosis.”

DG

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Reading of the Week: Tobacco, with Papers from JAMA and NEJM

January 22, 2026 /

From the Editor

The waiting room was filled with patients to see, so I concentrated on his history of alcohol misuse and opioids, and I glossed over his nicotine use. But does the path to sobriety in fact start with smoking cessation?

In a new JAMA Psychiatry paper, Michael J. Parks (of the National Institutes of Health) and his co-authors attempt to answer that question. They looked at whether smoking cessation increased sustained remission from substance use disorder (SUD) over time. They describe a longitudinal survey cohort study of more than 2 600 participants from the United States, followed for four years, finding that quitting cigarettes increased the odds of recovery from other SUDs by 30%. “In this cohort study, smoking cessation was linked to better SUD recovery outcomes, and it could improve overall health among the millions of US adults with a current SUD.” We discuss the paper and its implications.

In the second selection from The New England Journal of Medicine, Simon Gilbody (of the University of York) and his colleagues write about the challenges of tobacco in low- and middle- income countries. They note that 80% of tobacco users are in such countries, yet cessation programs aren’t prioritized, particularly absent for those with mental health conditions. “Therapeutic nihilism (the belief that no intervention will work) impedes change and is unjustified in this instance.”

And, in the third selection from JAMA Oncology, Dr. Chadi Nabhan (of the University of South Carolina) writes about his patient and lung cancer. He describes the incredible draw of tobacco – including as a way for his patient to cope with loneliness and isolation. “The cigarette was more than a source of nicotine.”

DG

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Reading of the Week: The Best of 2025

January 15, 2026 /

From the Editor

Welcome 2026.

It’s our tradition that the New Year starts with a review of the best papers of the past year. So, as we enter the first weeks of 2026, let’s look back at 2025.

The list is hardly exhaustive, and many great papers aren’t listed here. But there is an important thread that runs through all of them: they tie into our clinical work. These 10 papers selected are interesting, informative, and – yes – relevant.

They cover everything from AI to antidepressant withdrawal. And, yes, we touch on sex, too.

DG



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Reading of the Week: Antidepressants & Side Effects – the New Lancet Paper; Also, Medical Cannabis & Addiction, and AI Hallucinations

December 18, 2025 /

From the Editor

What are the physical side effects of antidepressants? In a new, impressive Lancet study, Toby Pillinger (of King’s College London) and his co-authors attempt to answer that old question with a new approach: the first systematic review and meta-analysis. They drew on 168 RCTs that measured physical health effects of antidepressants, including almost 59 000 participants and comparisons of 30 antidepressants. “We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters.” We consider the paper and its implications.

How safe is cannabis for those taking it for medical purposes? Dr. Beth Han (of NIMH) and her colleagues report findings from a US survey in a new JAMA Psychiatry brief report, focusing on cannabis use disorder (CUD). They report that cannabis use wasn’t less addictive when used for medical reasons. “Clinicians should consider addiction risk before recommending medical cannabis and, if they do, should monitor for CUD emergence.”

The BMJ runs humorous articles in its Christmas issue. The journal doesn’t disappoint this year. Dr. Roberto A. Correa Soto (of the Universidad de los Andes) and his co-authors write about AI hallucinations and doctor BS (yes, you read that correctly). Frankly, the paper is worth reading for the profanity alone. “Both doctors and large language models (LLMs) are driven to produce misinformation – ‘bullshit’ and ‘hallucinations’ – owing to a shared pressure to provide answers, prioritising the appearance of competence over accuracy.”

There will be no Readings for the next three weeks. 

DG

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Reading of the Week: Telemental Health Post-COVID – the New JAMA Psych Study; Also, GLP-1 RAs & Antipsychotics, and Depression & MS

December 11, 2025 /

From the Editor

In the first weeks of the pandemic, mental health services underwent rapid transformation. The webcam became an indispensable component of psychiatric practice.

What’s happened since the lockdowns? In a new paper for JAMA Psychiatry, Dr. Mark Olfson (of Columbia University) and his colleagues look at outpatient services in the United States. They drew on US survey data, analyzing the use of telemental health, hydrid, and in-person care. “The findings of this cross-sectional study indicate that telehealth has become a common means of receiving outpatient mental health care in the US, especially for resourced patients with less serious psychological distress who receive psychotherapy from mental health specialists.” We consider the paper and its implications.

Can semaglutide help those with schizophrenia? In the second selection, from JAMA Psychiatry, Marie R. Sass (of the Capitol Region of Denmark) and her co-authors report on an RCT where 104 participants received a glucagon-like peptide 1 receptor agonists or placebo, focusing on individuals with early-stage glycemic dysregulation. “Results of this randomized clinical trial show that adjunctive semaglutide significantly improved glycemic control and weight outcomes in individuals with schizophrenia spectrum disorders.” 

Finally, Drs. David E. Freedman and Anthony Feinstein (both of the University of Toronto) write about multiple sclerosis and depression for The Canadian Journal of Psychiatry. In a practical paper, they discuss therapy, medications, and more. “Depression is a manageable contributor to increased morbidity and mortality in people with MS.”

DG

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Reading of the Week: Cannabinoids for Therapeutic Use – the New JAMA Paper; Also, ECT and Szalavitz on Her Recovery & Substance Use

December 4, 2025 /

From the Editor

Cannabis for chronic pain? What about insomnia or seizures? Patients often ask about the therapeutic use of cannabis. And your patients aren’t the only ones thinking about it; more than one in four Americans have used cannabis for medicinal purposes. But what does the literature actually say?

In an impressive, new review paper just published in JAMA, Dr. Michael Hsu (of the University of California, Los Angeles) and his co-authors seek to answer that question. With 124 citations, they are thorough and thoughtful, drawing on studies, clinical guidelines, and more. They are also clear in their conclusion. “Despite the accumulation of new studies, evidence is insufficient for the use of cannabis or cannabinoids for most medical conditions.” We consider the paper and its implications.

In the second selection from The Lancet Psychiatry, Dr. Richard Braithwaite (of the Sussex Partnership NHS Foundation Trust) and his co-authors comment on ketamine for depression. Though some new studies have reported solid results comparable to ECT, they remain skeptical. “The claim that ketamine is equivalent to ECT is not supported by credible evidence. It is a narrative constructed on a foundation of a small number of inadequately designed trials and flawed meta-analyses.”

Is sobriety required for recovery from substance misuse? In a personal essay for The New York Times, writer Maia Szalavitz argues that it isn’t. She notes her own journey which has spanned 40 years. “In reality, most people who resolve addictions – including me – do not reject all substance use forever.”

DG

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Reading of the Week: Preventing PTSD – the New AJP Study; Also, AI Hallucinations and Dr. Gollapudi on Stethoscopes

November 27, 2025 /

From the Editor

Though years had passed since his peacekeeping service in Bosnia, my patient lucidly described the flashbacks and nightmares that still haunted him. It raises an important question: is it possible to prevent PTSD in the first place?

In a new, important American Journal of Psychiatry paper, Chelsea Dyan Gober Dykan (of Tel Aviv University) and her co-authors attempt to answer that question by drawing on past work showing the effectiveness of response-time-based attention bias modification (RT-based ABM), a cognitive training technique. They describe a three-arm randomized controlled trial involving more than 500 male combat-bound soldiers who, before combat exposure, received one of two cognitive training techniques (RT-based ABM and a variant focused on gaze) or a sham intervention. Participants then reported on PTSD symptoms after it. “Consistent with a previous randomized controlled trial, RT-based ABM reduced risk for PTSD relative to sham ABM when implemented prior to combat exposure.” We consider the paper and its implications.

How common are AI hallucinations? In the second selection, Jake Linardon (of Deakin University) and his co-authors look at hallucinations through the prism of psychiatry, asking ChatGPT to draft writing on several disorders. In their JMIR Mental Health study, hallucinations were frequent. “Citation fabrication and bibliographic errors remain common in GPT-4o outputs, with nearly two-thirds of citations being fabricated or inaccurate.”

Finally, in the third selection from Academic Psychiatry, Dr. Sheba Gollapudi (of the University of Texas) mulls the power of the stethoscope and its psychiatric equivalent. She describes how she developed her listening skills and her use of silence. “Because even though I will not necessarily use a stethoscope in my everyday practice, I know now that the stethoscope is within me.”

DG

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Reading of the Week: Mindfulness for Depression – the New Lancet Psych Study; Also, AI & Med Ed and the Latest in the News

November 20, 2025 /

From the Editor

He tried CBT, yet he remained deeply depressed. What should come next? For the record, my patient wasn’t enthusiastic about trying additional medications. Like many, he favoured psychotherapy to antidepressants. 

In a new Lancet Psychiatry paper, Thorsten Barnhofer (of the University of Surrey) and his co-authors attempt to shed light on the issue. They report on a randomized, controlled, superiority trial involving 234 participants who had depression and completed a dozen or more sessions of therapy – but remained ill. In the study, these participants received either mindfulness or treatment as usual and were followed for 34 weeks. “Our findings suggest that mindfulness-based treatment can be beneficial after non-remission from major depressive disorder following psychological, stepped care treatment.” We consider the study and its implications.

In the second selection, Yilin Ning (of the National University of Singapore) and her co-authors look at the potential of AI for medical education. In a paper for The Lancet Digital Health, they note great opportunities – particularly as low and middle-income nations face shortages of healthcare providers – but they also describe challenges. “AI offers great promise for enhancing the quality and accessibility of medical education and physician training, from personalised learning experiences to the simulation of complex clinical scenarios.”

Finally, we explore the latest news with articles from The New York Times and The Washington Post. The topics: the case for mandatory treatment, glucagon-like peptide-1 agonists for substance, and the life of Dr. Nolan Williams.

DG

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Reading of the Week: DBT vs Meds for BPD – the New AJP Paper; Also, OTC Naltrexone for Alcohol and Climate Change Anxiety in Canada

November 13, 2025 /

From the Editor

She presented to the emergency department with suicidal thoughts but no specific plan. She had been diagnosed with borderline personality disorder, and asked me a simple question: how can I do better?

In a new study published in The American Journal of Psychiatry, Beth S. Brodsky (of Columbia University) and her co-authors attempt to answer that question. 84 people with borderline personality disorder and past suicide attempts and/or self-harm behaviours were randomized and then offered either six months of therapy (DBT) or medications (SSRIs), and compared for the reduction of suicide attempts and self-harm. “DBT appears to work faster and perhaps more effectively in borderline personality disorder for suicide-related outcomes and for nonsuicidal self-injury compared with SSRIs plus clinical management.” We consider the study and its implications.

In the second selection from JAMA Psychiatry, Drs. Olga Terechin, Sofia E. Matta, and Joji Suzuki (all of Harvard University) propose that naltrexone be made available over the counter. Noting the deep problems of unhealthy alcohol use, they argue that greater availability of this medication would be important. “We believe that allowing OTC access to naltrexone would serve as a groundbreaking approach to addressing unhealthy alcohol use, particularly for individuals who are hesitant to seek help or live in areas where access to treatment is limited.”

And in the third selection, S. L. Harper (of the University of Alberta) and her co-authors look at climate change anxiety in Canada. Drawing on a survey with almost 2 500 participants, they analyzed prevalence and demographics in a Nature Mental Health paper. “Mild-to-moderate climate change anxiety in Canada is not uncommon… and certain demographic groups may require additional supports to manage and reduce the symptoms…” 

DG

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