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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