Author: David Gratzer

An estimated 11% of adolescents have an episode of depression by age 18 (Merikangas et al. 2010) and depressed youth are at greater risk of suicidality (Hawton, Saunders & O’Connor 2012), physical health problems including obesity (Goodman & Whitaker 2002), and high-risk behaviors (Armstrong & Costello 2002). However, only 60% of depressed adolescents receive treatment (Costello et al. 2014).

http://www.thementalelf.net/mental-health-conditions/depression/collaborative-care-for-adolescent-depression-new-rct-shows-promise/

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

With that strong introduction, a recent blog posting on The Mental Elf summarizes a major new JAMA paper on collaborative care for adolescents with depression. Continue reading

I have plenty of acquaintances, and a couple hundred ‘friends’ on Facebook. But real friends, mostly family, I can count on one hand. For me, making friends is like climbing a vertical rock wall with no ropes, requiring a degree of thrill-seeking, and a good deal of risk.

http://well.blogs.nytimes.com/2014/10/23/living-with-schizophrenia-coffee-and-friends/

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

This short New York Times essay describes the burden of living with Schizophrenia. Though just over 1,000 words, I think it explains the challenges of severe, persistent mental illness better than whole books written on the topic. Continue reading

By the 1880s, there were 75 psychiatric hospitals in the United States, and a survey estimated that less than 1% of prisoners had mental illness. For the next 90 years, it was widely accepted in the United States that people with mental illness belonged in hospitals rather than prisons.

Then it all came undone.

http://ajp.psychiatryonline.org/article.aspx?articleid=1911272

(Because of firewall issues, this link may not work. A PDF version of this article is attached.)

In this editorial in the current issue of the American Journal of Psychiatry, University of North Carolina’s Dr. David Rubinow considers the unintended consequences of de-institutionalization, the decades long push for the mentally ill to be moved out of hospitals and into the community – and often into the forensic system. Continue reading

I attended the funeral, albeit awkwardly. I told myself not to feel defensive. I could learn from this, but that didn’t make it right. I didn’t recover for a very long while.

http://www.thestar.com/news/insight/2014/10/03/a_patients_suicide_a_doctors_devastation.html

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

Dr. Paul Garfinkel has had a storied career — psychiatrist, prolific researcher, administrator. There’s even a street named after him in downtown Toronto.

He can now add to the resume: published author of a moving and thoughtful memoir. Continue reading

In Canada, we need to stop thinking of depression as a Cinderella disease — as deserving as its stepsisters, but neglected nonetheless.

http://www.cmaj.ca/content/early/2014/09/29/cmaj.141128.full.pdf+html Continue reading

http://www.newyorker.com/magazine/2014/09/22/home-free

Psychiatric patients often have problems beyond their core psychiatric issues. For people with severe, persistent mental illness, homelessness may be among them.

Continue reading

http://www.cmaj.ca/site/earlyreleases/9sept14_suicide-report-indicates-shift-at-WHO.xhtml

Yesterday was World Suicide Prevention Day.

The Reading of the Week, an article from CMAJ, touches on this topic and discusses the recently released WHO report, “Preventing Suicide: A global imperative.”

The WHO report finds:

• Every year, 800,000 people suicide.
• That works out to a suicide every 40 seconds.
• Suicide is the second leading cause of death worldwide for people 15 to 29 of age.

Continue reading

http://www.theguardian.com/society/2014/aug/28/cancer-depression-huge-treatment-effect-new-programme

How common is depression in cancer patients? Is it treatable?

Capping off an incredible effort, a series of papers was just published by the Lancet, the Lancet Oncology and the Lancet Psychiatry — 3 of the biggest journals in medicine.

Covering 21,000 patients with depression and cancer, the papers have important findings:

1. 73% of patients with depression and cancer go untreated for their mood disorder.

2. Depression is common in patients with cancer; depending on the type of cancer, 3 to 6.5 times more common than in the general population at a point in time.

3. And in smaller trials, cancer patients respond robustly to nurse-led, multi-modality treatment — even patients with poor (cancer) prognosis.

Continue reading

http://spectrum.ieee.org/biomedical/diagnostics/smartphone-app-keeps-watch-over-schizophrenic-patients

Today, you may watch an old high-school friend’s daughter take her first steps in Brazil (where they now live), cash a cheque into your bank account, and get live updates on Scotland’s referendum — and do all of this with your smartphone without leaving your living room. Technology has transformed our lives.

Will it transform Psychiatry? Continue reading