Tag: Burke

Reading of the Week: Placebo & Practice – the New Lancet Psych Paper; Also, Mortality & Opioids and Mental Health Awareness Campaigns

May 14, 2026 / / 0 Comments

From the Editor

The tone of our voice when discussing a treatment. The way we emphasize its benefits. Mention of our hopefulness. As clinicians, we are aware that small things can improve patient outcomes. To speak more technically: we harness placebo effects.

In an impressive new Lancet Psychiatry review, Dr. Matthew J. Burke (of the University of Toronto) and his co-authors examine placebo effects with an eye to the implications for clinical practice. They discuss imaging and physiology; they also mention depression and offer suggestions (including, yes, harnessing placebo effects). “The thoughtful application of placebo and nocebo effects has promise in enhancing patient care and treatment outcomes, but more research is needed to validate specific approaches.” We discuss the paper and its implications.

What is the survival rate after an opioid overdose? In a new research letter just published in JAMA, Dr. Robert A. Kleinman (of the University of Toronto) and his co-authors attempt to answer that question. Though they walk on a well-travelled path, they drew on data in this, the era of fentanyl. “Mortality was higher than estimates from previous research conducted prior to the widespread availability of fentanyl (5.3%-5.5%).”

And in the third selection from The Globe and Mail, Dr. Lester Liao (of McGill University) and his co-authors write about mental health campaigns. They note the unintended consequences, including overdiagnosis of disorders like ADHD and autism. “We started out with the greatest of intentions. Unintended consequences have arisen. That’s okay. We learn along the way. Now it’s time to change course.”

There will be no Reading next week.

DG

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Reading of the Week: When Physical Medicine Met Mental Health; New Papers from General Hospital Psychiatry and JAMA Neurology

October 17, 2019 /

From the Editor

In my last hospital job, an afternoon might involve seeing a gentleman with poorly controlled diabetes, a woman who wasn’t participating in her post-hip physiotherapy, and an ICU patient with multiple problems. The common thread: they all had psychiatric diagnoses (PTSD, depression, and delirium, respectively).

Patients with physical and mental health problems can be costly and complicated. They also pose a challenge for a health care system that is designed for the simplicity of tackling one problem at a time.

This week, we look at a couple of papers on this interface between mental and physical health.

In the first paper, the University of Rochester’s Mark A. Oldman and his co-authors wonder if proactive psychiatric consultations can reduce hospital length of stay. With a systematic review, they conclude: “Our review indicates that proactive models of CL psychiatry whose screening is enriched by clinical expertise in mental health care and that deliver enhanced, proactive mental health services appear to reduce LOS, with preliminary cost-benefit analyses reporting favorable returns on investment that more than offset the increased costs of providing this level of enhanced care.”

hospitalGood Hospital, Good CL Service?

In the second paper, the University of Toronto’s Matthew J. Burke, a neurologist, considers patients who present with symptoms unexplained by medical disease. “The irony of ‘it’s all in your head’ is that although this phrase is often used inappropriately and dismissively, it is technically correct.”

DG

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