Tag: Artificial Intelligence

Reading of the Week: Economic Burden of Depression – the New Nature Med Study; Also, AI & Delusions and Dr. Garfinkle-Crowell on Young Women

September 17, 2026 / / 0 Comments

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, with partnerships in seven countries and promotion in three more.  

A quick word of thanks for your ongoing interest.

We usually think about depression on the individual level – our patients tell stories of lost jobs, broken relationships, and personal tragedies. But what are the societal costs? In a new Nature Medicine paper, Zhong Cao (of Heidelberg University) and his co-authors attempt to answer that question. They analyzed World Bank data; using labour force participation, education, and work experience, they projected the global economic burden of depression to 2050. “Overall, depression places a heavy strain on the global economy, accounting for about 0.460% of the world’s annual GDP. This burden, however, is uneven across regions.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Philip R. Corlett (of Yale University) weighs in on AI and psychosis in a new commentary. Does AI cause psychosis? Does it exacerbate problems for those who are vulnerable? Corlett reviews this young literature and offers his thoughts. “I suspect that they are not merely old wine in new bottles, but rather new wine in new bottles.”

Finally, in the third selection, Dr. Suzanne Garfinkle-Crowell (of the Icahn School of Medicine at Mount Sinai) writes about therapy-speak and young women for The New York Times. She describes the trend and its implications – and warns against dismissing it. “Ideally, we should create an environment in which girls can stop blaming their own brains for every problem and where they don’t feel they have to be sick to be heard.”

DG

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Reading of the Week: Psychosocial Care After War – The New Lancet Psych Paper; Also, AI vs Physicians (JAMA) and the Latest in the News

September 10, 2026 /

From the Editor

He survived the civil war. But nightmares haunted him and he rarely left his apartment. My patient had survived, yes, but his mental health problems, untreated in his home country, tormented him. In a world of war and violence, my patient’s experiences – the mental illness and the lack of care – are all too common. 

With few psychiatrists and psychologists, could non-specialist providers help fill the treatment gap? Anushka R. Patel (of Harvard University) and her co-authors attempt to answer that question in an impressive new systematic review and meta-analysis published in Lancet Psychiatry. Drawing on a quarter century of studies and involving more than 10 000 survivors, they compared non-specialist care with a relatively inactive control. “Our findings support the overall effectiveness of non-specialist provider-delivered psychosocial interventions for violence survivors…” We consider the paper and its implications.

In the second selection, from JAMA, Dr. Ezekiel J. Emanuel and his co-authors write thoughtfully if controversially about artificial intelligence. While many assume that medicine will be reshaped by the collaboration of physicians and computers, they suggest otherwise, focusing on five cognitive medical tasks. “That in the near future AI alone may provide better patient care than physicians or physician-controlled hybrids at 5 fundamental cognitive medical tasks is unsettling but seems probable.”

Finally, we review the latest news with articles from The Toronto Star, The Wall Street Journal, and The Globe and Mail. The topics: addiction treatment, the bias of therapists, and the PTSD and research of Margaret McKinnon.

DG

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Reading of the Week: Measurement-based Care – the New Psych Services Paper; Also, Agentic AI, and Dr. Johari on Losing a Patient

August 13, 2026 /

From the Editor

Studies show that measurement-based care improves patient outcomes, from better functioning to fewer readmissions. Not surprisingly, expert practice guidelines, including the CANMAT clinical guidelines for depression, recommend their use. Yet – despite years of enthusiasm – most of us don’t use scales or questionnaires to monitor symptoms and outcomes.

In a new systematic literature review, Christian Burr (of the Bern University of Applied Sciences) and his co-authors try to identify effective strategies by analyzing recent studies. In their Psychiatric Services paper, they focused on 16 studies in a systematic literature review. “Effective measurement-based care implementation requires context-sensitive strategies, interprofessional collaboration, and active involvement of patients, service users, and caregivers.” We consider the paper and its implications.

In the second selection from The British Journal of Psychiatry, Dr. Scott Monteith (of Michigan State University) and his co-authors write about the evolution of artificial intelligence. They focus on agentic AI (arguably the next big thing), seeing a clear role in education, yes, and in patient care – but they also note problems. “Agentic artificial intelligence systems offer a unique approach to supporting physicians in dealing with the challenges of clinical medicine but also pose validity, privacy, malpractice and security risks.”

And in this week’s final selection, Dr. Paniz Johari, a psychiatrist who works at Northwell Health, writes personally and thoughtfully about the loss of her patient to suicide. In JAMA, she discusses her grief and rumination. “The absence of anything remarkable made it harder to understand and harder to set aside.”

DG

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Reading of the Week: Pediatric Self-Injury – the New JAMA Peds Study; Also, Lithium as King, and High-Risk Human-AI Engagement

June 4, 2026 /

From the Editor

Recently, I saw an adolescent who described using self-harm as a way to cope. She discussed learning different techniques through social media. “At first, I thought it was strange.”

Presentations of self-injury appear to be becoming more common. How often are healthcare visits for it? How commonly do youth report self-injury? Have these numbers changed over time? In a new study published in JAMA Pediatrics, Dr. Natasha Saunders (of the University of Toronto) and her co-authors attempt to address these questions by drawing on 42 studies with a combined population of 234 million individuals across a dozen nations over a 25-year period. They conducted a systematic review and meta-analysis, finding an average 3.5% relative annual increase. “These findings highlight a consistent rise in health care encounters and self-reported self-injury among children and youth, particularly female individuals, over the past 2 decades.” We consider the study and its implications.

In the second selection from The British Journal of Psychiatry, Dr. Gurubhaskar Shivakumar (of The University of Sydney) and his co-authors write about lithium. They note its declining use and the problems with its safety. Yet they argue that lithium remains the “king” of bipolar disorder treatment. “Ever since its discovery, lithium continues to command authority having repeatedly reclaimed its throne.” 

Finally, in the third selection, Dr. Lena Palaniyappan (of McGill University) and his co-authors discuss high-risk human-AI relationships in a paper for The Canadian Journal of Psychiatry. They offer a framework and constructive suggestions – both highly relevant in the age of AI chatbots. “Risk for problematic AI engagement cuts across diagnostic categories, rooted in distress, isolation, and cognitive style.”

DG

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Reading of the Week: MST vs ECT – the New Lancet Psychiatry Paper; Also, the First AI Drug Prescriber and Dr. Taglienti on Her Cancer & Her Career

April 23, 2026 /

From the Editor

He began to respond to ECT and felt less depressed than he had in many years. But as the treatments continued, my patient noticed gaps in his memory including family vacations when his children were young. “Those memories are precious.” He stopped ECT and, soon after, was deeply depressed again. 

Smaller studies suggest that Magnetic Seizure Therapy (MST) – where alternating magnetic fields induce seizures – offers relief to patients without the cognitive problems of ECT. In a new study published by The Lancet Psychiatry, Dr. Daniel M. Blumberger (of the University of Toronto) and his co-authors add to the literature with the largest randomized trial comparing these convulsive therapies conducted and the first non-inferiority clinical trial to address efficacy. The study involved 239 participants with depression. “MST showed non-inferior efficacy relative to… ECT in achieving remission of depression, and a more favourable cognitive safety profile.” We consider the paper and its implications.

Should patients receive prescriptions from an AI prescriber? In the second selection, from JAMA, Dr. Daniel G. Aaron (of the University of Utah) and Christopher Robertson (of Boston University) look at a new Utah program allowing AI to prescribe medications without physician involvement. They are cool to the idea. “Although AI offers the promise of increased efficiency and expanded access, the evasion of legal obligations by early movers raises profound concerns. Incorporating AI into modern health care must be evidence based and responsible.”

And in the third selection, Dr. Jenna Taglienti (of Hofstra University) writes personally about her cancer in JAMA. As a psychiatrist and a residency program director, she finds meaning in her work – but illness helps her gain perspective. “Medicine can have extraordinary meaning. But it cannot substitute for being present in your own life.”

DG

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Reading of the Week: Mirtazapine for Methamphetamine – the New JAMA Psych Study; Also, Patients & AI and Delgaram-Nejad on His Meds

April 16, 2026 /

From the Editor

He occasionally used cannabis in his 20s and did not try crystal methamphetamine until after his 35th birthday. He readily admits to problematic use, undermining his relationship and leading to the loss of his job. In my office, he describes his desperation and asks: Is there a medication that could help?

In the first selection, a new paper published in JAMA Psychiatry, Rebecca McKetin (of the University of New South Wales) and her co-authors attempt to answer that question. In an impressive new study, they report the results of a phase 3, parallel-group, double-blind, placebo-controlled RCT involving 344 people with moderate or severe methamphetamine use disorder and a trial of mirtazapine or placebo. “The results of this randomized clinical trial confirm that mirtazapine can be used in routine clinical practice to facilitate a reduction in methamphetamine use among people with a moderate to severe methamphetamine use disorder.” We consider the paper and its implications.

In the second selection, Shaddy K. Saba and Dr. William B. Weeks (both of New York University) write on AI and patients. In a commentary for JAMA Psychiatry, the authors observe that an increasing number of patients are turning to AI and argue that clinicians need to become actively involved. “The question is not whether AI is good or bad for mental health: like many other patient behaviors, it can be both and depends on context. The question for clinicians is whether to help patients navigate its use.”

Finally, in the third selection from Schizophrenia Bulletin, Oliver Delgaram-Nejad – who has schizophrenia – discusses his decision to stop medication. Reviewing his episodes of psychosis, he argues that antipsychotics are too problematic for him. “I have weighed the benefits and risks, and navigated the rather painful tension, of remaining on an antipsychotic and living with the side effects versus accepting the risk of relapse and reclaiming my energy.”

DG

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Reading of the Week: Psychotic Prompts & AI – from JAMA Psych; Also, Lithium Landscape and Dr. Cooke on Growing Up

April 2, 2026 /

From the Editor

Patients, including those with psychosis, may turn to AI chatbots for advice. What are they told? And are they encouraged to seek care?

In a research letter that was recently published in JAMA Psychiatry, Dr. Elaine Shen (of Columbia University) and her co-authors attempt to answer these questions. Using three versions of ChatGPT, they provided 79 statements indicative of positive psychotic symptoms and 79 that were neutral. The responses were then rated by two reviewers. With the free version of ChatGPT – what most people use – psychotic prompts had 43-fold higher cumulative odds of receiving a less appropriate rating than control prompts. We consider the study and its implications.

Lithium has fallen out of fashion; a recent Canadian paper found declining prescriptions in Alberta. In a new American Journal of Psychiatry commentary, Dr. Robert M. Post (of George Washington University) and his co-authors make the case for the old mood stabilizer. They offer several arguments, including that it is a disease-modifying agent. “Clinicians, patients, and the public should be educated about the unique assets of lithium, such that conventional treatment paradigms of bipolar disorder emphasize the greater and earlier use of the drug to achieve a more benign course of illness and less cognitive dysfunction.”

Finally, in the third selection from JAMA, Dr. Emma M. Cooke (of Harvard University) writes about medical school rotations. Now an internist, she remembers the common med school question: “what do you want to do when you grow up?” She mulls her responses – and the simplicity of the question. “For everyone in medicine, not just medical students, our choice of specialty is just a single data point in what makes us who we are.”

DG


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Reading of the Week: Adolescent Mental Health With Papers on School-Based Mindfulness, Firearms & Youth Suicide, and GenAI

February 26, 2026 /

From the Editor

The MYRIAD Trial was ambitious, involving more than 8 300 adolescents at 84 schools, with the aim of preventing depression and improving mental well-being by teaching mindfulness through a universal school program. The only catch? There was no difference in outcomes at one year.

Would it be possible to identify adolescents who would benefit from mindfulness? Christian A. Webb (of Harvard University) and his co-authors attempt to answer that question, using AI. And so, a longstanding objective, prevention, was joined with a modern method, machine learning. In the first selection, a paper from JAMA Psychiatry, the authors detail a secondary analysis using two complementary machine learning approaches and the MYRIAD Trial data. “This study found that analyses using machine learning identified a subgroup of participants with a statistically detectable but clinically trivial differential intervention response. These findings highlight the substantial challenges in achieving clinically useful personalization in universal school-based prevention programs.” We consider the paper and its implications.

In the second selection, from the Journal of the American Academy of Child & Adolescent Psychiatry, Alison Athey (of Johns Hopkins University) and her co-authors evaluate the impact of child access prevention laws on youth suicide deaths by firearms. They drew on more than 30 years of mortality data from the Centers for Disease Control and Prevention. “Laws that require families to store firearms unloaded and secured in a locking device appear to effectively prevent youth suicide deaths and firearm-related youth deaths by accident and homicide.”

And in this week’s third selection, Dr. Scott Monteith (of Michigan State University) and his co-authors write about generative AI and adolescents for The British Journal of Psychiatry. They note a surge in use – some 80% of British teens use generative AI – and consider problems, from cyberbullying to mental healthcare. “There is a need to increase awareness of how GenAI may have a negative impact on the mental health of teenagers.”

DG

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Reading of the Week: AI Scribes in Primary Care – the New JAMA Psych Paper; Also, Antidepressant Prescribing and the Life & Death of Carol Sauer

February 5, 2026 /

From the Editor

More physicians are turning to AI scribes to free up time. But what is the impact on clinical care?

In a new JAMA Psychiatry paper, Victor M. Castro (of Harvard University) and his co-authors attempt to answer that question by looking at scribes in primary care. In a cohort study drawing on more than 20 000 routine annual visits, they compared documentation and management of neuropsychiatric symptoms. “Incorporation of AI ambient scribes in primary care was associated with greater levels of neuropsychiatric symptom documentation but lesser likelihood of documented management of psychiatric symptoms.” We consider the paper and its implications.

In the second selection, a letter published in The Canadian Journal of Psychiatry, Dionzie Ong (of the University of British Columbia) and her co-authors consider antidepressant prescribing and evidence, focusing on citalopram and escitalopram. “Preferential prescribing of escitalopram and claims of superiority are not supported by science.”

Finally, in the third selection, Washington Post reporter Dana Hedgpeth writes about the life and death of Carol Sauer, who spent years experiencing homelessness. She had graduated from high school, attended university, and held jobs until 2000, when she became ill. A person who read her death notice on social media comments: “I cried thinking about her. This beautiful woman sitting for 20 years at a bus stop and nobody could make a difference… It’s a reminder of the power and responsibility we have to help those who are homeless and mentally ill.” 

DG

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Reading of the Week: Yoga for Opioid Withdrawal? The New JAMA Psych Paper; Also, MAOIs & History, and AI-Associated Psychosis

January 29, 2026 /

From the Editor

Yoga is increasingly recognized as having a role in the treatment of those with mood and anxiety problems. But what about substance misuse?

In the first selection, from JAMA Psychiatry, Suddala Goutham (of the National Institute of Mental Health and Neurosciences, Bengaluru, India) and his co-authors attempt to answer that question in a new, early-stage randomized clinical trial. In the study, 59 men were randomized to yoga and buprenorphine or buprenorphine alone. “Those receiving yoga alongside standard buprenorphine treatment achieved withdrawal stabilization 4.4 times faster than controls (median, 5 vs 9 days) and showed significant improvements in heart rate variability, anxiety, sleep, and pain measures.” We consider the study and its implications.

In the second selection, from The Journal of Clinical Psychiatry, Vincent Van den Eynde (of Radboud University) and his co-authors write about the MAOI class of antidepressants. In a commentary paper, they argue that these medications are underappreciated. “We thus emphasize the need for renewed attention to the classic MAOIs in clinical practice and research.”

And in the third selection, Dr. Joseph M. Pierre (of the University of California, San Francisco) and his co-authors write about AI-associated psychosis for Innovations in Clinical Neuroscience. They discuss what they suggest is the first journal-published case report, detailing the struggles of a practicing medical professional. “Although multiple pre-existing risk factors may be associated with psychosis proneness, the sycophancy of AI chatbots together with AI chatbot immersion and deification on the part of users may represent particular red flags for the emergence of AI-associated psychosis.”

DG

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