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Reading of the Week: Doctors & Suicidality – the New CMAJ Study; Also, GLP-1 RAs & Eating Disorders, and Chin-Yee on the Death of the Consult Note

July 9, 2026 / / 0 Comments

From the Editor

His suicidal thoughts were so strong that he had written a suicide note. Yet, during the months before we met in the ED, he had hesitated to seek care. As a doctor, he knew he had severe depression but he told me that he felt he couldn’t get help. 

Such stories are all too common. In a CMAJ study, Dr. An Yi (Annie) Yu (of the University of Toronto) and her co-authors shed light on physicians’ seeking help for suicidality. They drew from the literature (literally): analyzing 52 narratives from academic papers, finding various barriers to seeking care, including aspects of medical culture, and identified facilitators, such as confidential services. “The pressure to achieve in medicine often discourages physicians from acknowledging their need for help, but the value of meaningful work emerged as a positive factor for mental health. The stigma regarding mental health concerns was substantially reduced through role modelling of help-seeking behaviour by colleagues.” We consider the study and its implications.

GLP-1 receptor agonists are having a moment because of the evidence for diabetes and other conditions. In the second selection, Nicholas C. Peiper (of the University of Louisville) and his co-authors focus on those with eating disorders, analyzing data to understand use and misuse in a new JAMA Psychiatry research letter. “This cross-sectional study found that GLP-1 RA use and misuse were common in a targeted sample of people with eating disorders.”

And in the third selection, from JAMA, Dr. Benjamin Chin-Yee (of Western University) writes about consult notes. He wonders what is lost in the “digital transformation” of templates and AI scribes. He worries about the future of the consult note. “The tools may evolve, but the art of pausing, thinking, and telling a story is still ours to preserve.”

DG

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Reading of the Week: The Placebo Effect and Antidepressants

November 3, 2016 /

From the Editor

Is the placebo effect getting stronger with time?

image001Placebo pills – greater importance?

Since the first writings of English physician John Haygarth at the turn of the 19th century, the placebo effect is something well documented and well discussed – but not well understood. How can people respond to sugar pills and the like?

Even more oddly, the placebo effect seems to be changing with time, at least in terms of antidepressant medications. In a classic paper published about a decade and a half ago, Walsh et al. found that the placebo effect was getting more pronounced over the years. Dr. Timothy Walsh joked in a Washington Post interview that “[t]hey’re making placebos better and better.” Besides being an interesting finding, there are larger issues – start with the implications to drug development. After all, if the placebo effect is rising, it becomes more challenging to develop a drug that bests it.

Have things changed since the publication of the Walsh et al. paper?

In this week’s Reading, we consider the new Furukawa et al. paper. This study, which reviewed 250 plus randomized controlled trials that involved more than 26,000 patients and included unpublished data, found that the placebo effect isn’t increasing. Also in the Reading: an editorial commenting on the Furukawa et al. paper.

Please note – there will be no Reading next week.

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Reading of the Week: Cancer and Mental Illness

May 19, 2016 /

From the Editor

“Now that I’m done with my [cancer] treatment, I’m struggling to figure out who I am,” writes essayist Suleika Jaouad.

This week’s Reading focuses on cancer and mental illness.

We open with a major new paper just published by JAMA Oncology (involving hundreds of thousands of cancer patients) and we then consider an essay by Suleika Jaouad talking about how cancer affected her physical and mental health.

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Our New Paper: “Making Evidence-Based Psychotherapy More Accessible in Canada”

April 7, 2016 /

Happy to see that our paper has just been published (online first) in The Canadian Journal of Psychiatry. And what a great project. My co-author, Dr. David Goldbloom, is a former supervisor from my training, a mentor, and a friend. Back in residency, we talked about a joint project – so glad that, after a few years, it happened.

As usual, I learned much from working with him.

You can find the paper here:

http://cpa.sagepub.com/content/early/2016/04/05/0706743716642416.full.pdf+html

Reading of the Week: Big Study on a Big Problem: Stigma & Mental Health, and More

March 31, 2016 /

From the Editor

Stigma. Suicide prevention.

This week we consider these weighty topics with two excellent papers.

The first, written by Patten et al., looks at the perception of stigma in those receiving mental health care in Canada. The second is a “viewpoint” that asks what we need to do to reduce suicide rates – which, across the West, has not decreased in the past decade.

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Our CMAJ Paper

March 29, 2016 /

Happy to see our review paper on iCBT has been printed in CMAJ, the country’s oldest medical journal.

And thrilled to see us land the front cover of the 1 March 16 issue.

Reading of the Week: David Cameron’s “Life Chances” Speech, And More

March 17, 2016 /

From the Editor

As stigma fades, as mental health problems are recognized and discussed, we have an opportunity to re-think old approaches.

This week, the Readings touch on two large issues: how to handle mental illness in our society, and what to do about addiction and the law. The first comes from a recent speech by the Prime Minister of Britain; the second, from an editorial in The Lancet Psychiatry.

 

Readings have drawn from many sources over these past few years – journals, books, and newspapers. This is the first time we’ve looked to 10 Downing Street for material. But perhaps it wouldn’t be the last time. More and more, people discuss these issues with thoughtful comments; the political class can be counted among them. #Progress

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