Tag: cardiac

Reading of the Week: Cannabis & Cardiac Health – the New JAHA Study; Also, Burnout & Outcomes, and Dr. Mary Seeman on Scaling Down

From the Editor

Our patients increasingly use cannabis, and we worry about the impact on their mental health. But what about the impact on their physical health?

In the first selection, Abra M. Jeffers (of Harvard University) and her co-authors consider cannabis and cardiac health. In a new paper for the Journal of the American Heart Association, they analyzed cardiac outcomes, drawing on survey data and involving more than 400 000 participants, some of whom used cannabis. “Cannabis use is associated with adverse cardiovascular outcomes, with heavier use (more days per month) associated with higher odds of adverse outcomes.” We review the paper and its implications.

In the second selection, Nina A. Sayer (of the University of Minneapolis) and her co-authors look at burnout in a new paper for JAMA Network Open. In a cohort study involving 165 therapists and almost 1 300 patients, they note a connection between provider burnout and PTSD outcomes. “These findings suggest that interventions to reduce therapist burnout might also result in more patients experiencing clinically meaningful improvement…”

Dr. Mary Seeman (of the University of Toronto), who died in late April, had a storied career as a psychiatrist. She had major roles, including the Tapscott Chair in Schizophrenia at the University of Toronto. In a 2003 paper for The American Journal of Psychiatry, she reflects on her work with a patient. This essay – the third selection this week – notes the decades-long connection between doctor and patient. “Her faith in me keeps me coming into work each morning, often tired and achy, sometimes trying unsuccessfully to remember the comforting word I want to be able to say.”

DG

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Reading of the Week: Cardiovascular Diseases & Mental Disorders – The New AJP Paper; Also, Systematic Racism & Depression (JAMA Psych)

From the Editor

When people with mental health problems have physical illness, how does their care measure up?

Not surprisingly, we worry about their access and follow up. Evidence suggests poorer outcomes. But how do people with mental disorders fare on an international basis?

In the first selection, Dr. Marco Solmi (of the University of Padua) and his co-authors try to answer that question, focusing on cardiovascular diseases (CVD). In a new American Journal of Psychiatry paper, they conduct a systematic review and meta-analysis, drawing on the data of more than 24 million people. (!) They find: “People with mental disorders, and those with schizophrenia in particular, receive less screening and lower-quality treatment for CVD. It is of paramount importance to address underprescribing of CVD medications and underutilization of diagnostic and therapeutic procedures across all mental disorders.” We discuss the paper and its clinical implications.

heart-palpitations

In the second selection from The American Journal of Psychiatry, Drs. Nathalie Moise and Sidney Hankerson (both of Columbia University) consider structural racism and depression care, using a clinical vignette. Rather than just seeing the patient’s experience in terms of genetic loading and medications, they describe a person who has struggled with various forms of racism. They argue: “Mental health professionals need to recognize the effect of structural, individual, and internalized racism on individuals with depression symptoms.”

DG
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