Month: July 2019

Reading of the Week: Care – At the System Level, At the Individual Level

July 25, 2019 /

From the Editor

As stigma fades, there is increasing interest in mental health care. But how can we best help those who need help?

This week, we consider three selections. From an opinion piece written by a politician to a study in a leading journal, there is a common thread: how to improve care, whether at the individual level or at the system level.

In our first selection, we consider a new paper from The Canadian Journal of Psychiatry. Evgenia Gatov (a senior epidemiologist at ICES) and her co-authors consider trauma in the inpatient population, with a big finding. “In this population-based study of adult psychiatric inpatients in Ontario, Canada, almost one in three individuals reported prior experiences of interpersonal trauma.”

19609_mainInpatient Care: a need for trauma care?

In our second selection, Dr. Adam Philip Stern (of Harvard Medical School) discusses the challenges of being a patient and a psychiatrist. Dr. Stern – ill with cancer – is in psychotherapy. He discusses much, including the value of connectedness.

And, in our third selection, we look at an essay by Boris Johnson (the new Prime Minister of the United Kingdom) who discusses depression and work. He advocates for tax changes making it easier for companies to help mentally ill employees.

Enjoy.

DG

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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)

July 18, 2019 /

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: ‘Sister First, Doctor Second’ – Dr. Sediqzadah’s NEJM Paper on Her Brother and His Illness

July 11, 2019 /

From the Editor

“‘I think your brother has schizophrenia,’ she said.

“I was entering my third year of medical school when I received a phone call from my brother’s friend.”

So begins a perspective paper published in today’s issue of The New England Journal of Medicine. The essay is deeply moving. Written by Dr. Saadia Sediqzadah, a fifth year psychiatry resident at the University of Toronto, the author discusses her brother’s schizophrenia and her family’s efforts to get him care – for Dr. Sediqzadah, dealing with mental illness is not just part of her training.

inclusion-programs-18Saadia Sediqzadah

This week, we consider Dr. Sediqzadah’s paper.

Note that for some of our younger colleagues who have just finished their medical training and begun their specialty training in psychiatry, this week will be your first Reading. Welcome to the conversation.

DG

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