Tag: addiction

Reading of the Week: Bipolar & Med Adherence – the New Journal of Affective Disorders Study; Also, Sleep (QT) and Sheff on Involuntary Treatment (NYT)

From the Editor

You wrote a prescription, but did he actually take the medications? For those with bipolar disorder, pharmacotherapy is an essential part of care. Studies have noted poor adherence. 

To date, though, there hasn’t been a big cohort study. And there are good questions to ask: what drugs are more linked with adherence? Who is more likely not to take the medications? In a new paper just published in the Journal of Affective Disorders, Dr. Jonne Lintunen (of the University of Eastern Finland) and his co-authors attempt to answer these questions. They draw on Finnish data, covering more than three decades and including over 33 000 patients. “The majority of patients with bipolar disorder do not use their medications as prescribed.” We consider the paper and its clinical implications.

In the second selection, Dr. Michael Mak (of the University of Toronto) comments on sleep in a new Quick Takes podcast interview. In this sleep “update,” we talk about meds, CBT, and the mobile apps that he recommends to patients and their families. We also explore the history of sleep medicine and mull the growing role apps and wearables are playing in both diagnosis and therapy. “The lines between sleep, health, and mental health in general are blurred.”

In the third selection, author David Sheff talks about his son’s addiction and recovery – and involuntary treatment. In a New York Times’ essay, he notes the challenges of engaging those with substance problems. He sees several ways forward, including involuntary treatment. “Many people in the traditional recovery world believe that we must wait for people who are addicted to hit bottom, with the hope that they’ll choose to enter treatment. It’s an archaic and dangerous theory.”


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Reading of the Week: Resilience after Disaster – Lessons from Japan; Also, Schizophrenia & Spending (CJP) and Dr. Brandeland on Her Father & His Addiction (JAMA)

From the Editor

My patient was involved in a terrible car accident. Though physically unharmed, she’s never really recovered (mentally). Her co-worker, sitting in the seat beside her, barely took off any time from work.

Why are some people resilient and others aren’t?

In The British Journal of Psychiatry, Dr. Taku Saito (of the National Defense Medical College) and his co-authors explore this question, focusing on a natural disaster. Drawing on an impressive database of first responders involved in the 2011 Japanese earthquake rescue/recovery effort, they do a seven-year prospective cohort study. They find: “The majority of first responders… were resilient and developed few or no PTSD symptoms.” Of course, some did develop mental health problems. The risk factors? Older age, personal disaster experiences, and working conditions. We consider the big paper.

In the second selection, Andrew J. Stewart (of the University of Calgary) and his co-authors analyze health spending in a new Canadian Journal of Psychiatry paper. They focus on people with schizophrenia, looking at a 10-year period. “Healthcare spending among patients with schizophrenia continues to increase and may be partially attributable to growing rates of multimorbidity within this population.”

And, in the third selection, Dr. Megan Ann Brandeland (of Stanford University) writes about her father’s death. In JAMA, she discusses his struggles and notes that – early in his career as a physician – a patient had a tragic outcome. “My hope in sharing this story is to encourage more physicians to share their own stories, to reduce the stigma around mental health, trauma, and addiction among physicians, and to honor my father’s life and the goodness he brought to the world.”

Please note that there will be no Reading next week; we will resume on 31 March 2022.


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Reading of the Week: Breaking the Stigma – Dr. Adam B. Hill on his Depression and Addiction

From the Editor

“My name is Adam. I am a human being, a husband, a father, a pediatric palliative care physician, and an associate residency director. I have a history of depression and suicidal ideation and am a recovering alcoholic.”

So begins this week’s selection, which is an essay written with remarkable candor and honesty.

1docDiscussing what we should discuss

In this Reading, Dr. Adam Hill writes in The New England Journal of Medicine about his struggle with mental illness.

It is moving and important.

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