Month: November 2025

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

Continue reading

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

Continue reading

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

Continue reading

Reading of the Week: Novel Depression Care – the New JAMA Psychiatry Study; Also, Psych Beds in the US and ChatGPT & Sensitive Conversations

November 6, 2025 /

From the Editor

He had several antidepressant trials. rTMS was helpful but the improvement faded quickly. Should he try ketamine? My patient had read good things and asked.

In a new paper for JAMA Psychiatry, Ana Jelovac (of Trinity College Dublin) and her co-authors attempt to answer that question. 62 hospitalized patients with depression were randomly assigned to receive either repeated ketamine or midazolam treatment and were followed for 24 weeks afterwards. “Serial adjunctive ketamine infusions were not more effective than serial midazolam infusions in reducing depressive symptoms in inpatients receiving usual psychiatric care.” We consider the paper and its implications.

How has the supply of US psychiatric beds changed with time? In the second selection, from JAMA Psychiatry, Karen Shen (of Johns Hopkins University) and her co-authors drew on US databases, finding a slight reduction in overall beds but perhaps an increase in acute care supply, albeit with an increase in beds from large for-profit hospital chains. “Given reports of safety concerns at large for-profit chains, our findings also underscore the need for research on the effects of growing corporatization of inpatient mental health care on patient outcomes.”

And in the third selection, published on their website, ChatGPT staff write about recent controversies involving those with mental health problems, suggesting that the organization has been moved to action. The essay describes their efforts to make advice safer and more appropriate for users who are psychotic, suicidal, or becoming emotionally reliant on AI. “We worked with more than 170 mental health experts to help ChatGPT more reliably recognize signs of distress, respond with care, and guide people toward real-world support – reducing responses that fall short of our desired behavior by 65-80%.”

DG

Continue reading