From the Editor
What do you say to your patient when he insists that cannabis is helping him with his mental disorder? What is the evidence?
Of course, many papers have been published on the topic. That said, Jack Wilson (of The University of Sydney) and his co-authors contribute nicely to the literature with their new systematic review and meta-analysis – arguably the most comprehensive to date – published in Lancet Psychiatry. 54 RCTs were included, involving almost 2 500 participants, including those with depression and PTSD. “Given the scarcity of evidence, the routine use of cannabinoids for the treatment of mental disorders and substance use disorders is currently rarely justified.” We discuss the paper and its implications.
What happens to your view of our field after five decades spent treating tens of thousands of patients, leading major institutions, and authoring dozens of books and papers? In a new episode of Quick Takes, Dr. Joel Paris, former chair of the Department of Psychiatry at McGill University and a self-proclaimed skeptic, discusses the past, present, and future of psychiatry. Never one to shy away from sharing his controversial views, Dr. Paris dives into his thoughts on the DSM system (he’s not a fan) and what he sees as “fads and facilities” – such as the overdiagnosis of adult ADHD, trauma, and autism. “Over time, my perspective on psychiatry has changed in the direction of greater skepticism.”
Finally, in the third selection from The Canadian Journal of Psychiatry, Drs. Kenya A. Costa-Dookhan and Andrew Lustig (both of the University of Toronto) discuss what to do when a patient doesn’t meet criteria for an involuntary admission but isn’t well. Drawing on a case involving a patient experiencing a manic episode, they offer three strategies. “When mania outruns the law, our task is to accompany our patients with clarity, compassion, and collective integrity, not toward cure, but toward the next opportunity for care.”
DG
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