Tag: Ayers

Reading of the Week: Written Exposure Therapy for PTSD – the New JAMA Psychiatry Paper; Also, #MedEd & Knowledge Translation

From the Editor

How to help those with PTSD? Prolonged exposure therapy (PE) and cognitive processing therapy (CPT) are supported by good evidence but both are resource intense and often have high drop-out rates, partly because of the requirement that patients complete homework. Is there an alternative?

In the first selection, we look at a new study considering written exposure therapy (WET), an emerging therapy where patients write about traumatic events – but the therapy doesn’t demand so much from the system (in terms of resources) or patients (in terms of homework assignments). Denise Sloan (of Boston University) and her colleagues conducted a noninferiority trial, comparing this therapy with prolonged exposure therapy for US veterans with PTSD, involving 178 participants from three centres. “We found WET was noninferior to PE, a treatment that includes more treatment sessions, longer sessions, and between-session assignments.” We consider the study, an Editorial responding to it, and mull the clinical implications.

In the last selection, John W. Ayers (of the University of California San Diego, La Jolla) and his co-authors consider social media and medical education in JAMA. They argue that #MedEd is a dynamic platform with the potential to democratize medical education – but also warn of the problems of misinformation. “The potential for #MedEd to improve medical education and the health sciences is considerable, while the risks of dismissing #MedEd is potentially greater.”

DG

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Reading of the Week: Lithium Prescribing – the New CJP Paper; Also, AI vs. Doctors (JAMA Int Med) and Bergner on Compulsory Mental Health (NYT)

From the Editor

For patients with bipolar disorder, lithium is an important medication, shown to reduce hospitalizations and suicides better than newer agents. But has it fallen out of fashion? International reports suggest that it has.

In the first selection, Samreen Shafiq (of the University of Calgary) and her co-authors try to answer this question with Canadian data in a new paper for The Canadian Journal of Psychiatry. They draw on a decade of Alberta prescription data with more than 580,000 lithium scripts. “This population-based study suggests that the overall number of new and prevalent lithium users is decreasing in Alberta between the years of 2009 and 2018, but the observed pattern suggests that this decrease may have stopped by the end of our study interval.” We consider the paper and its clinical implications.

In the second selection, John W. Ayers (of University of California San Diego) considers AI-generated responses to health care questions posted on social media, like the need to seek medical attention after a minor head injury with a presentation of a lump and a headache. In a JAMA Internal Medicine paper, they compare ChatGPT answers to those of physicians in terms of quality and empathy. “In this cross-sectional study, a chatbot generated quality and empathetic responses to patient questions posed in an online forum.”

The debate over coercive care is hot, with proposals to rebalance patients’ rights actively discussed in New York City, Alberta, and California. In the third selection, author Daniel Bergner writes that we should look for alternatives to medications. In a New York Times essay, he argues that antipsychotics are problematic. “By doubling down on existing methods, we’re only beckoning more failure.”

DG

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Reading of the Week: “13 Reasons Why” – Is This TV Show Glamorizing Suicide?

From the Editor

Is a popular TV show glamorizing suicide?

13 Reasons Why is a Netflix series in which the main character suicides – depicted graphically in the show. We will leave it to critics to judge the value of the show as a cultural contribution. Here’s a relevant question for those of us in mental health: is this show promoting suicide?

San Diego State University John W. Ayers and his co-authors consider google searches after the show’s premiere aired, bringing data to this discussion.

13 Reason Why: Popular Show, Problematic Effect?

In this Reading, we consider their research letter and an editorial responding to it – and the larger debate about the series.

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