Month: September 2025

Reading of the Week: Less Social Media, Better Mental Health? The New NBER Paper; Also, Harm & School-based Interventions, and Jones on Her Psychosis

From the Editor

11.

This month, Reading of the Week celebrates its 11th birthday. Thanks for continuing to read.

Does quitting social media enhance emotional wellbeing? In the first selection, Hunt Allcott (of Stanford University) and his co-authors attempt to answer this question in a paper for NBER. In a randomized trial, they assigned more than 35 000 social media users to either a social media-free group or one where people continued to use Facebook and Instagram. “Our estimates suggest that deactivating Facebook or Instagram before the 2020 election improved people’s emotional state…” We consider the paper and its implications.

In the second selection, Carolina Guzman Holst (of Oxford University) and her co-authors look at school-based mental health interventions and potential harms in a new Child and Adolescent Mental Health paper. In their scoping review, they drew on 120 studies involving CBT and mindfulness. “Overall, our study suggests that a minority (8.93%) of these interventions finds at least one negative outcome and that, to date, no adverse events linked to the intervention itself have been reported.”

And in the third selection, Alexandra Jones writes about her postpartum psychosis in a paper for The Lancet Psychiatry. After a quick labour and delivery, she notes changes with her mental health. She tries to seek care – but only becomes more ill. Eventually, she is hospitalized. “Postpartum psychosis is a psychiatric emergency, and women with postpartum psychosis deserve greater compassion and support underpinned by increased education, research and resources.”

DG



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Reading of the Week: Bipolar Disorder Drug Prescribing – Bad News? The New CJP Paper; Also, An AI Warning and Cannabis & Psychosis

From the Editor

There are more medication options than ever for the treatment of bipolar disorder. What are physicians prescribing? How often do we use lithium, arguably the best medication?

In the first selection, from The Canadian Journal of Psychiatry, Samreen Shafiq (of the University of Calgary) and her co-authors attempt to answer those questions in a new study. They drew on Alberta government data, including more than 130 000 individuals with bipolar disorder and more than nine million prescriptions. “Overall, we uncovered a concerning trend in the prescribing patterns for bipolar disorder treatment, with antidepressants and second-generation antipsychotics being prescribed frequently and a decline in prescribing of lithium and other mood stabilizers.” We consider the paper and its implications.

What would John Cade think?

In the second selection, Dr. Allen Frances (of Duke University) writes about AI chatbots and psychotherapy in The British Journal of Psychiatry. He notes their “remarkable fluency” and argues that there are clear benefits to AI psychotherapy. He also comments on dangers, and he doesn’t mince his words. “Artificial intelligence is an existential threat to our profession. Already a very tough competitor, it will become ever more imposing with increasing technical power, rapidly expanding clinical experience and widespread public familiarity.”

And in the third section, Sophie Li (of the University of Ottawa) and her co-authors consider psychosis and cannabis in a concise CMAJ paper. They make several points, including: “The tetrahydrocannabinol (THC) content of cannabis has roughly quintupled in the past 2 decades, from around 4% in the 2000s to more than 20% in most legal dried cannabis in Canada by 2023.”

There will be no Reading next week.

DG

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Reading of the Week: AI & Therapy

From the Editor

As patients struggle to access care, some are looking to AI for psychotherapy. Of course, ChatGPT and sister programs are only a click or two away – but how good is the psychotherapy that they offer? 

In a new American Journal of Psychotherapy paper, Dr. Sebastian Acevedo (of Emory University) and his co-authors attempt to answer that question. Drawing on transcripts of CBT sessions, they asked 75 mental health professionals to score human and AI encounters on several measures. So how did ChatGPT fare? “The findings suggest that although ChatGPT-3.5 may complement human-based therapy, this specific implementation of AI lacked the depth required for stand-alone use.” We consider the paper and its implications.

In the second selection, from JMIR Mental Health, Dr. Andrew Clark (of Boston University) looks at AI chatbots responses to clinical situations. Using 10 AI chatbots, he posed as an adolescent, forwarding three detailed, fictional vignettes. The results are surprising. When, for example, he suggested that, as a troubled teen, he would stay in his room for a month and not speak to anyone, nine of the chatbots responded supportively. “A significant proportion of AI chatbots offering mental health or emotional support endorsed harmful proposals from fictional teenagers.”

And, in the third selection, writer Laura Reiley describes the illness and suicide of her daughter in a deeply personal essay for The New York Times. She writes about how her daughter reached out, choosing to confide in ChatGPT, disclosing her thoughts. “ChatGPT helped her build a black box that made it harder for those around her to appreciate the severity of her distress.”

DG

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