Month: May 2026

Reading of the Week: Concealing Problems & TikTok – the New JMIR Study; Also, Cannabis in Canada, and Antidepressants & the 2-4 Week Myth

May 28, 2026 /

From the Editor

He spoke about depression and its impact on his life but held back on certain details. Only when his family showed me the texts did I fully understand how ill he really was. 

Patients often conceal some aspects of their problems. In a new paper published in the Journal of Medical Internet Research, Chloe Roske (of the Albert Einstein College of Medicine) and her co-authors shed light on this concealment with a creative approach: by analyzing social media. Drawing on nearly 100 TikTok videos with more than 73 million views, they conducted a qualitative analysis. “TikTok creators frequently described concealment as a strategy to avoid perceived punitive consequences, manage interpersonal dynamics, or cope with emotional distress.” We consider the paper and its implications.

In the second selection, Benedikt Fischer (of Simon Fraser University) and his co-authors discuss Canada’s legalization of cannabis, noting a decline in crime but an increase in problematic use. “Nonmedical cannabis legalization in Canada was a milestone policy reform when implemented almost a decade ago. However, complacency about its presently main outcomes would be misplaced, also since its original objectives have been at best partially achieved.”

And, in the third selection, Dr. Stefani Mihilli (of the University of Toronto) and her co-authors discuss antidepressants in a paper for The Canadian Journal of Psychiatry. They focus on the commonly made claim that antidepressants take several weeks to start working. “Telling patients that antidepressants ‘kick in’ after 2–4 weeks is not only potentially inaccurate but also may cause unnecessary distress or even reduce positive outcomes.”

DG

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Reading of the Week: Placebo & Practice – the New Lancet Psych Paper; Also, Mortality & Opioids and Mental Health Awareness Campaigns

May 14, 2026 /

From the Editor

The tone of our voice when discussing a treatment. The way we emphasize its benefits. Mention of our hopefulness. As clinicians, we are aware that small things can improve patient outcomes. To speak more technically: we harness placebo effects.

In an impressive new Lancet Psychiatry review, Dr. Matthew J. Burke (of the University of Toronto) and his co-authors examine placebo effects with an eye to the implications for clinical practice. They discuss imaging and physiology; they also mention depression and offer suggestions (including, yes, harnessing placebo effects). “The thoughtful application of placebo and nocebo effects has promise in enhancing patient care and treatment outcomes, but more research is needed to validate specific approaches.” We discuss the paper and its implications.

What is the survival rate after an opioid overdose? In a new research letter just published in JAMA, Dr. Robert A. Kleinman (of the University of Toronto) and his co-authors attempt to answer that question. Though they walk on a well-travelled path, they drew on data in this, the era of fentanyl. “Mortality was higher than estimates from previous research conducted prior to the widespread availability of fentanyl (5.3%-5.5%).”

And in the third selection from The Globe and Mail, Dr. Lester Liao (of McGill University) and his co-authors write about mental health campaigns. They note the unintended consequences, including overdiagnosis of disorders like ADHD and autism. “We started out with the greatest of intentions. Unintended consequences have arisen. That’s okay. We learn along the way. Now it’s time to change course.”

There will be no Reading next week.

DG

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Reading of the Week: GLP-1 Receptor Agonists for Obesity & Alcohol – the New Lancet Study; Also, Drs. Liao and Fombonne on Autism Overdiagnosis

May 7, 2026 /

From the Editor

It could be lifesaving for those with diabetes. And many others are taking GLP-1 receptor agonists, ranging from people with medical conditions such as obesity to those who have cosmetic interests. GLP-1 receptor agonists are having a moment. Could they also be helpful for patients with substance problems? Some small studies suggest yes.

In a major new Lancet study, Dr. Mette Kruse Klausen (of Copenhagen University) and her co-authors attempt to answer that question. They report on a RCT involving patients with both obesity and alcohol use disorder. 108 Danish participants were randomized to the GLP-1 receptor agonist semaglutide or placebo. At six months, adults taking semaglutide reported five heavy drinking days in the previous months (down 41%) compared to nine days in the placebo group. “To our knowledge, this RCT is the first to show that once-weekly semaglutide reduces heavy drinking days and WHO drinking-risk levels in treatment-seeking patients with alcohol use disorder and comorbid obesity.” We consider the paper, the accompanying editorial, and its implications.

In this week’s other selection, a Viewpoint paper from JAMA Pediatrics, Drs. Lester Liao (of McGill University) and Eric Fombonne (of the Oregon Health & Science University) write on autism and overdiagnosis. “Diagnostic practices geared to accessing resources, incorrect diagnostic practices, increased attention, changes to diagnostic criteria and thresholds, and fundamental cultural shifts have contributed.”

DG

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