Month: March 2026

Reading of the Week: Personalized Antidepressant Treatment – the New JAMA Study; Also, Social Media Use & Adolescent Well-Being

From the Editor

Some patients with depression don’t show improvement. Among the reasons why: they may stop treatment too early. For decades, research on improving outcomes has included biomarkers, trying to better pair illness with treatment. But what about following patient preferences in care decisions? Can this help bolster medication compliance and thus improve outcomes?

In a new, compelling paper that was just published in JAMA, Dr. Andrea Cipriani (of the University of Oxford) and his co-authors attempt to answer these questions. They describe a study involving 540 participants in 47 sites. Participants were randomized to receive either the usual care or care using the PETRUSHKA tool, “a web-based clinical decision-support system combining clinical and demographic predictors with patient preferences to personalize antidepressant treatment.” The results are impressive. “Compared with usual care, participants with MDD whose antidepressant was selected using the PETRUSHKA tool had a reduced risk by approximately 40% of discontinuing their antidepressant during the first 8 weeks of treatment.” We consider the paper and its implications, as well as the accompanying Editorial.

The impact of social media on children and adolescents is much discussed; recently, Australia banned youth who are under 16 years of age from using platforms like Instagram. In this week’s other selection, from JAMA Pediatrics, Ben Singh (of the University of South Australia) and his co-authors analyzed social media’s association with well-being. They describe a cohort study of more than 100 000 Australian adolescents who were followed for three years. They found: “a U-shaped association emerged where moderate social media use was associated with the best well-being outcomes, while both no use and highest use were associated with poorer well-being.”

Note: there will be no Readings for the next two weeks.

DG

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Reading of the Week: ECT in Ontario – the New CJP Study; Also, Alcohol & Influencers, and Jayaraman on Chekhov’s Guns

From the Editor

It’s the most effective treatment for those with treatment-resistant depression. Older studies, including one from Quebec, suggest that it’s much less used than in the past. Is ECT going the way of the dodo bird?

In a new Canadian Journal of Psychiatry study, Dr. Tyler S. Kaster (of the University of Toronto) and his co-authors attempt to answer that question. They drew on 17 years of data, tapping several administrative databases from Ontario, covering more than 450 000 treatments. They offer some good news. “We found that while ECT use generally increased over time, there were notable differences between biological sexes, age groups, and geographic regions.” We consider the paper and its implications.

In the second selection, a research letter published in JAMA Pediatrics, Scott I. Donaldson (of Rutgers University) and his co-authors connect social media content with the desire to drink among young people. Drawing on survey data, they analyzed the impact of lifestyle influencers. “This experimental evidence adds to a growing body of research showing that exposure to alcohol-promoting content, particularly on social media, is associated with alcohol-promoting attitudes and behaviors in young adults.” 

Finally, in the third selection, Pranav Jayaraman (of Texas Tech University) writes about diagnoses and patients in Academic Psychiatry. The medical student discusses the temptation to reduce experiences to simple diagnoses. “As I seek to serve patients through psychiatry, a field often facing provider capacity and time constraints, the desire to pinpoint a single cause and address it with a straightforward solution is understandable but can also be limiting.”

DG

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