Month: January 2023

Reading of the Week: CBT for Depression – the Latest Evidence; Also, Digital Mental Health (World Psych) and Dr. Castro-Frenzel on Her Cancer (JAMA)

January 26, 2023 /

From the Editor

Cognitive behavioural therapy is widely used for the treatment of depression – but the last significant meta-analysis was published a decade ago. What’s the latest evidence? 

In the first selection, Pim Cuijpers (of the Vrije Universiteit Amsterdam) and his co-authors try to answer this question with a new meta-analysis including more than 400 randomized trials with almost 53 000 patients (yes, you read that correctly). In this World Psychiatry paper, they compare the therapy with controls, other therapies, and medications. They write: “We can conclude that CBT is effective in the treatment of depression with a moderate to large effect size, and that its effect is still significant up to 12 months.” We consider the paper and its clinical implications.

Beck: the father of CBT

In the second selection, Dr. John Torous (of Harvard University) and his co-authors look at digital mental health. Despite widespread use of smartphones – perhaps 80% of the world’s population now has access to one – “digital mental health is not transforming care.” In this Editorial for World Psychiatry, they wonder why. They also point a way forward: “Developing a new generation of digital mental health tools/services to support more accessible, effective and equitable care is the true innovation ready to be stoked today by each person who becomes empowered to connect, set up, engage, start/stop, and demand more from mental health technology.”

Finally, in the third selection, Dr. Karla Castro-Frenzel (of the University of Central Florida) writes about a patient with advanced lung cancer. As it turns out, she’s that patient. In this personal essay published in JAMA, she writes about being a doctor and a patient. “My ultimate hope… is that we can create space for illness as well as wellness. In helping our colleagues feel safe and supported when they become patients, we rehumanize our environments and our very selves.”

DG

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Reading of the Week: Antipsychotics – Good for Work Ability? Also, Mental Health Research Funding (CJP) and Murdoch on Her Career (CBC)

January 19, 2023 /

From the Editor

As clinicians, we often think about symptoms and symptom scales – important measures of a patient’s journey. Patients may focus on other things, like functionality, including employment.

Do antipsychotics help those with psychosis for their ability to work? Do some antipsychotics provide more advantage than others? Dr. Marco Solmi (of the University of Ottawa) and his co-authors try to answer these questions in a new American Journal of Psychiatry paper. They draw on Swedish databases involving more 21,000 people. They conclude: “Among individuals with first-episode nonaffective psychosis, antipsychotic treatment (with long-acting injectables in particular) was associated with about 30%–50% lower risk of work disability compared with nonuse of antipsychotics in the same individuals, which held true beyond 5 years after first diagnosis.” We consider the paper and its clinical implications.

In the second selection, Florence Dzierszinski (of the University of Ottawa) and her co-authors look at mental health research funding in Canada. In a Commentary for The Canadian Journal of Psychiatry, they argue that funding is lacking and, in fact, declining. They write that: “Adequate research funding could go a long way to addressing prevention, care, and treatment for the one in four Canadians who experience mental health problems in a given year, improving outcomes for individuals and for Canada’s society and economy.”

And in the third selection, published by CBC First Person, Darleen Murdoch talks about her career and retirement – and her diagnosis. She notes that, during her first hospitalization decades before, she was told by her physician she would never work. She writes: “In my own way, I have proven to the medical field that ‘miracles’ can happen.”

DG

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Reading of the Week: The Best of 2022

January 12, 2023 /

From the Editor

Welcome 2023.

It’s our tradition that we begin the New Year by reviewing the best of the past year; so, this week, we look back at 2022.

But a bit of a break from tradition: this year, we haven’t organized the papers by different categories, instead choosing eight great papers. Some have been published in big journals; others, not so big. They cover a variety of topics, from prevention to cutting-edge treatments. The one common thread: all are clinically relevant. And, yes, there is a Person of the Year. Spoiler alert: he had a big career and likes to mention Groucho Marx.

An observation about this past year: the quality of scholarship was very high. We’ve picked good papers – but could have picked scores of others. It’s a comment we’ve made in past years, and a good reason for optimism as our field grows more sophisticated and relevant.

DG

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