Tag: BMJ Mental Health

Reading of the Week: Preventing Mental Disorders After Disasters – the New BMJ Ment Health Paper; Also, Healthy Device Use and Dr. Qayyum on Regret

April 17, 2025 / / 0 Comments

From the Editor

Floods. Hurricanes. Fire. Extreme weather seems to be more common these days – resulting in some experiencing PTSD and other mental disorders. In an age of climate change, what can mental health services offer? Is it possible to prevent major mental illness with interventions like CBT?

Ahlke Kip (of the University of Münster) and her co-authors attempt to answer these questions in a new meta-analysis and systematic review which assesses the efficacy of psychological and psychosocial interventions after exposure to natural hazards. In the BMJ Mental Health paper, they looked at 10 RCT studies involving more than 5 000 participants, including both civilians and disaster responders, focusing on symptoms of PTSD, depression, and anxiety. They didn’t find superiority to passive control conditions. “The current evidence does not allow for any recommendations regarding prevention programmes in the aftermath of natural hazards.” We consider the paper and its implications.

In the second selection, Joseph Firth (of the University of Manchester) and his co-authors weigh in on youth and digital device usage. In a paper for World Psychiatry, they sought “directly actionable advice” for parents and youth and then drew on the literature to create tips for teenagers. “We sought to produce a set of best-practice approaches, on the basis of available evidence and guidelines, for adolescents and their parents looking to improve their device usage patterns.”

And in this week’s third selection, Dr. Zheala Qayyum (of Harvard University) writes about guilt and time in a paper for Academic Psychiatry. The child and adolescent psychiatrist describes an unkind act in her youth – and an opportunity to make amends decades later. She also notes the tie to training and education. “Only by sharing and reflecting on our own moments, successes, failures, and vulnerabilities, can our trainees recognize and respond to such instances in their own experience.”

DG

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Reading of the Week: Psychiatry & Daily Life with Papers on Mood Variation, Loneliness, and the Fear of Miscarriage

February 27, 2025 /

From the Editor 

In recent months, we have covered topics such as emerging evidence for a new medication treatment for alcohol use disorder, a new, short therapy for PTSD, and recommendations for managing insomnia. But what about psychiatry and daily life? This week, we make a bit of a pivot and ask: Should we have more morning meetings? How do we understand loneliness? And is the fear of miscarriage in need of its own (Greek-based) medical term? 

How does mood and anxiety vary over the course of the day, the week, and the season? In the first selection, Feifei Bu (of University College London) and her co-authors try answer that question in a new paper for BMJ Mental Health. Drawing on nearly a million observations, they assess time-of-day association with depression, anxiety, well-being, and loneliness. “Generally, things do indeed seem better in the morning.” We consider the paper and its implications – including whether morning meetings are, in fact, ideal.

Early morning, better mood?

Loneliness is increasingly recognized as a societal problem. A few years ago, the UK government created a Cabinet position to focus on the issue; Time magazine applauded “the World’s First Loneliness Minister.” In a new review for Nature Mental Health, Brendan E. Walsh (of the University of South Florida) and his co-authors push past the rhetoric and focus on the concept – or, rather, a couple of them. Walsh et al. then analyze demographics and propose treatments. “This Review is intended to be heuristic and to inspire future inquiry research across disciplines, including public health, psychology, healthcare, and social work/community health.”

And in the third selection, nurse Ruth Oshikanlu and Dr. Babatunde A. Gbolade (of the University of Leeds) discuss the fear of miscarriage. In a British Journal of Psychiatry letter, they argue that pregnant women worry about it, and a formal medical term (and more research) is needed. “We believe that apotychiaphobia, our proposed label for the fear of miscarriage experienced by pregnant women, goes beyond semantics. It entails appreciation for the emotional turmoil that many pregnant women face in silence.”

DG

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Reading of the Week: More Therapy, More Inequity? The New JAMA Psych Study; Also, Dr. Reimer on Living with Depression and Generative AI & Biases

January 23, 2025 /

From the Editor

What has been the most significant innovation in mental healthcare delivery in recent years? It wasn’t a new medication or therapy, but the widespread adoption of the webcam in 2020. Over the course of a handful of pandemic weeks, psychiatrists and therapists switched to virtual sessions, making it easier for people to receive care, including psychotherapy, unbound by geography, and thus addressing inequity – or, at least, that was the hope. As noted recently in The New York Times: “In the 1990s, teletherapy was championed as a way to reach disadvantaged patients living in remote locations where there were few psychiatrists. A decade later, it was presented as a more accessible alternative to face-to-face sessions, one that could radically lower barriers to care.”

So, are more people receiving psychotherapy? And has this new era of virtual care resulted in better access for all? Dr. Mark Olfson (of Columbia University) and his co-authors attempt to answer these questions in a new paper for JAMA Psychiatry. Drawing on the data of more than 90 000 Americans, they analyzed trends in outpatient psychotherapy in the US, finding more care than ever before. That said, they note greater inequity: “psychotherapy use increased significantly faster among several socioeconomically advantaged groups and that inequalities were evident in teletherapy access.” We consider the study and its implications.

As doctors, we often shy away from discussing our health, especially our mental health – even with our own physicians. This is particularly concerning because doctors have a higher suicide rate than the general population, yet fears of vulnerability, judgment, and stigma keep many of us silent. In this episode of Quick Takes, I sit down with Dr. Joss Reimer, president of the Canadian Medical Association, who openly shares her own experiences with depression, as a doctor and as a patient. “We all need help sometimes.”

And in the third selection, Matthew Flathers (of Harvard University) et al. analyze AI depictions of psychiatric diagnoses in a new paper for BMJ Mental Health. They tested two AI image models with different diagnoses and commented on the results. “Generative AI models acquire biases at every stage of their development – from societal prejudice in online training data, to the optimisation metrics and safety guidelines each developer puts in place. These layered biases persist even when their precise origins remain elusive.”

DG

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Reading of the Week: Cancer & Suicide & Good News – the New Transl Psychiatry Study; Also, AI & Therapy Dropouts, and Bland on Her Father & His D-Day

June 13, 2024 /

From the Editor

He was so overwhelmed by the cancer diagnosis that he didn’t eat or sleep for days. “It was my worst nightmare.” My patient isn’t alone in that devastating experience, of course – the diagnosis and treatment of cancer is a major life event. Not surprisingly, the suicide rate is roughly double that of the general population in the United States. But with increasing psychosocial interventions, how has this changed over time?

In the first selection, Qiang Liu (of the Chinese Academy of Medical Sciences) and his co-authors attempt to answer that question in a new paper for Translational Psychiatry. Drawing on 40 years of data and a major US database, they analyzed the journeys of five million cancer patients, discovering good news. “We revealed a gradual increase in cancer-related suicide rates from 1975 to 1989, followed by a gradual decrease from 1989 to 2013, and a marked decrease from 2013 to 2017.” Indeed, between 2013 and 2017, the rate dropped by 27%. We consider the paper and its implications.

In the second selection, Sakiko Yasukawa (of the Sony Corporation) and her co-authors aimed to reduce dropouts from psychotherapy using AI. In a new paper for BMJ Mental Health, they describe an RCT involving 149 people. “The results suggest that the personalised messages sent by the chatbot helped participants control their pace in attending lessons and improve programme adherence without human guidance.”

Last week marked the anniversary of D-Day with ceremonies, including in Normandy. What was the toll on those who returned home? In the third selection, an essay published in The Globe and Mail, Normanne Bland describes her father and his time in Europe. She writes about him with mixed feelings, coloured by his mental health problems, including PTSD. “I had a complicated relationship with my father. I was proud of his service but I loathed his drinking.”

There will be no Reading next week.

DG

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