Tag: Australian & New Zealand Journal of Psychiatry

Reading of the Week: Clozapine Monitoring – the New BJP Paper; Also, Suicide Trends Among Adolescents (CJP) and Van Gogh’s Ear & Iconography (ANZJP)

June 15, 2023 /

From the Editor

“Despite its strong evidence base, clozapine remains grossly under-prescribed in clinical practice. Although reasons for this are multifaceted, a commonly cited influence is the need for mandatory haematological monitoring.” So notes Ebenezer Oloyede (of the University of Oxford) and his co-authors in a new British Journal of Psychiatry paper. Could the requirements be simplified? 

In the first selection, Oloyede et al. look at outcomes of 569 patients on clozapine when, during the pandemic, routine blood monitoring was changed. In this mirror-image cohort study, they find: “[E]xtending the haematological monitoring interval from 4-weekly to 12-weekly did not increase the incidence of life-threatening agranulocytosis in people taking clozapine.” We consider the paper and its implications.

In the second selection, Dr. Rachel H. B. Mitchell (of the University of Toronto) and her co-authors analyze Canadian data on suicide and sex differences. In this Canadian Journal of Psychiatry research article, they find that suicide rates among female adolescents aged 10 to 14 years surpassed similarly aged males in 2011. “The marked and consistent trend of rising suicide rates among adolescent females aged 10 to 14 years in Canada signals increased distress and/or maladaptive coping in this segment of the population.” 

And in the third selection, Alexander Smith (of the University of Bern) and his co-authors write about Vincent van Gogh. In an Editorial for the Australian and New Zealand Journal of Psychiatry, they describe his mental health struggles but also their commercialization. “Vincent van Gogh’s ear has generated an intrinsic cultural currency. Yet, the psychiatric vulnerabilities encompassed by his act of self-harm are not always sensitively considered or acknowledged.”

DG

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Reading of the Week: Lithium & Renal Health – the New Lancet Psych Paper; Also, COVID & Suicides (ANZJP)

October 27, 2022 /

From the Editor

After starting lithium in the hospital, his life was transformed. My patient didn’t have another hospitalization, and he went back to excelling at his job and raising his young family.

There are many lithium success stories. But how safe is it for our patients’ kidneys? Though lithium has been used for decades, there is still controversy. We know that lithium can affect the kidneys, but how much renal change is naturally occurring (aging), due to psychiatric illnesses (like bipolar), or the medication itself?

In a new paper just published in The Lancet Psychiatry, Filip Fransson (of King’s College London) and his co-authors attempt to answer these questions with a cross-sectional cohort study drawing on 2,200 people from Sweden. They review kidney function over time for the general population, those with schizoaffective disorder and bipolar, and compare them to those on lithium. They find a significant connection between lithium and renal decline, but only after a decade of use. We consider the paper and its clinical implications.

In the second selection, Dr. Nick Glozier (of The University of Sydney) and his co-authors consider suicide rates during the pandemic in a new research article for the Australian & New Zealand Journal of Psychiatry. They note the dire predictions – of a “suicide epidemic” – that weren’t realized, and consider why, noting several factors, including that the economic downturn was mitigated by government action. Ultimately, though, they write: “suicide is an inherently difficult (stochastic) event to predict.”

DG

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Reading of the Week: Twitter & Suicide – the New ANZJP Paper; Also, Crystal Meth Use (Quick Takes) and Patients and Physicians’ Names (JAMA Net Open)

October 20, 2022 /

From the Editor

More and more, people use social media to debate current events, share personal experiences, and maybe enjoy a cat video or two. But if people are disclosing much, are they discussing suicidal thoughts? Could certain social media posts encourage people to get help?

In the first selection, Dr. Thomas Niederkrotenthaler (of the Medical University of Vienna) and his co-authors attempt to answer these questions with a new paper just published in the Australian & New Zealand Journal of Psychiatry. Drawing on more than 7.15 million tweets (from Twitter) and employing a machine learning approach, they divide content into several categories, then review volumes of calls to a suicide hotline and completed suicides. “This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths.” We mull the paper and its implications.

Social media: more than cat videos?

In this week’s second selection, we consider a new Quick Takes podcast interview with Dr. David Castle (of the University of Toronto). Dr. Castle discusses crystal methamphetamine, a drug used more and more in Canada. Drawing on his Australian experience and noting the rise in use here, he comments: “it’s highly prevalent, highly available, highly pure and highly destructive.”

Finally, in the third selection, Dr. Jamison A. Harvey (of the Mayo Clinic) and her co-authors take a look at communication between patients and their physicians. Drawing on nearly 30,000 email messages, they consider the way patients address their physicians in a new JAMA Network Open research letter. “This is the first study to objectively identify patterns of addressing physicians through electronic messaging and may reveal potential bias. We found that women physicians… and primary care physicians were addressed by their first name more frequently.”

DG

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Reading of the Week: Less & Less – Psychiatrists & Psychotherapy; Also, Transgender Individuals & Care (Psych Services) and Digital Mental Health (ANZJP)

January 20, 2022 /

From the Editor

“For much of the 20th century, psychotherapy was viewed as synonymous with psychiatry and was the primary treatment modality employed by outpatient psychiatrists.” 

Daniel Tadmon and Dr. Mark Olfson (both of Columbia University) observe this in a new paper. But times have changed; has the practice of psychiatry moved away from psychotherapy?

This week, there are three selections. The first is a new paper from The American Journal of Psychiatry that looks at psychotherapy provided by US psychiatrists. Drawing on decades of data, Tadmon and Olfson find: “While a small group of psychiatrists (11% – 15%) continued to provide psychotherapy in all patient visits, in the 2010s, about half of psychiatrists did not provide psychotherapy at all, and those who provided psychotherapy in some patient visits came to do so more and more rarely.” We consider the paper and its implications.

Sorry Freud: most psychiatrists don’t practice psychotherapy

In the second selection, Dr. June Sing Hong Lam and his co-authors consider the mental health experiences of transgender individuals. In a Psychiatric Services paper, they draw on administrative databases focusing on both ED visits and hospitalizations. They conclude: “This study found that transgender individuals presenting for acute mental health care were more likely to experience marginalization than cisgender individuals and to present to acute care with different diagnostic patterns.”

Finally, in the third selection, Dr. Aswin Ratheesh and Mario Alvarez-Jimenez (both of the University of Melbourne) consider digital mental health and the post-pandemic world. In the Australian & New Zealand Journal of Psychiatry, they write about various problems (for instance, with digital privacy). Still, they see much potential: “Effective digital tools, especially when blended and responsive can radically improve the availability of mental health care in our corner of resource-rich, yet manpower-poor world.”

Please note that there will be no Reading next week.

DG

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