Author: David Gratzer

You can’t change what you can’t measure.

So suggests Dr. David Goldbloom, Chair of the Mental Health Commission of Canada, on the release of the Commission’s new report.

Reports from government and government agencies aren’t exactly uncommon in health care. Too often, they are heavy in rhetoric and light in impact. Last Thursday, the Commission released: Informing the Future: Mental Health Indicators for Canada. This report is different; it’s worth careful consideration. The Commission’s work offers the first national-level set of indicators to identify and report on Canadians’ mental health. This report considers 13 indicators; in April, a fuller report will contain 63 indicators.

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On the Reading of the Week

Just a quick reminder: this week’s Reading is the second in a two-part, two-paper series. The selection was made with the editorial board of the International Psychiatry Twitter Journal Club, allowing us to consider these papers here, and to continue the conversation on Twitter.

And that conversation is going on today. Continue reading

Kids are different today, I hear ev’ry mother say

Mother needs something today to calm her down
And though she’s not really ill, there’s a little yellow pill
She goes running for the shelter of a mother’s little helper
And it helps her on her way, gets her through her busy day

– Mother’s Little Helper, The Rolling Stones

On the Reading of the Week

This Reading will be part of a two-paper, two-part series. The selection was made with the editorial board of the International Psychiatry Twitter Journal Club, allowing us to consider these papers now, and to continue the conversation on Twitter and include experts from Canada and around the world. Continue reading

Vivian Rakoff, the chair of the University of Toronto’s Department of Psychiatry during the 1980s and one of the legends of Canadian psychiatry, used to say that psychiatry was both a science and an art, and the essence was to balance the two. More than four decades later, his words ring as true as ever.

So begins Dr. Paul Garfinkel in the chapter “Science and Care” of his newly released autobiography, A Life in Psychiatry: Looking out, Looking in.

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It has the feel of a bad movie.

When the BBC goes to interview psychiatrist Dr. Egip Bolsane in his native Chad, they find a man in a small office with a small wooden desk. Dr. Bolsane speaks enthusiastically about his work, wiping sweat from his forehead (he can’t afford an air conditioner) as he talks about the challenges of practice in a country where mental illness is often confused with possession.

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When was the last time you recommended exercise to one of your depressed patients?

Too often, we tend to be too selective with our patients, choosing to talk up the drugs, and choosing not to talk about the other things that can help.

It’s a problem not confined to clinicians: 2014 seems to be the Year of the Obscure Depression Treatment. The American Journal of Psychiatry has published papers on ketamine and NSAIDs. The New York Times ran an op ed suggesting that mushrooms may be the future of treatment (citing the British Journal of Psychiatry, no less).

And with such attention-grabbing remedies, exercise seems so much less dazzling.

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Case study: Bryan is a 57 year old male who is employed as a graphic designer. He has Bipolar Affective Disorder and has frequent episodes. “Being bipolar is like jumping out of an airplane knowing you don’t have a parachute on. You know you’re going to be hurt, but the high is so euphoric that it’s worth the risk. You can deal with the consequences later.”

Question: Can technology help this patient stay healthy and out of hospital?

http://www.wired.com/2014/11/mental-health-apps/

(Because of firewall issues, this link may not work. The article follows.)

This week’s Reading isn’t from a peer-reviewed journal, it’s from Wired. Continue reading

If the extent of human suffering were used to decide which diseases deserve the most medical attention, then depression would be near the top of the list. More than 350 million people are affected by depression, making it one of the most common disorders in the world. It is the biggest cause of disability, and as many as two-thirds of those who commit suicide have the condition.

“But although depression is common, it is often ignored.

http://www.nature.com/news/medical-research-if-depression-were-cancer-1.16307

First published in 1869, Nature is one of the most cited scientific publications. It is also one of the most read (Nature claims an online readership of 3 million unique readers a month).

This special issue of Nature is dedicated to Depression.

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To our knowledge, the current study is the first report to demonstrate a potential effect of these psychosocial interventions on telomere length (TL) among distressed breast cancer survivors.

http://onlinelibrary.wiley.com/doi/10.1002/cncr.29063/full

(Because of browser and firewall issues, this link may not work. The paper is attached in PDF format.)

My impression of this paper in two words: seriously cool. Continue reading