Tag: CBT

Reading of the Week: Depression and Employment

May 14, 2015 /

I want to get back to work… I want to get back to my life.

A patient recently made this comment to me. Before his depression, he had thrived at a government job and taken great pride in his work. (He showed me iPhone pictures of an event he had helped organize which was keynoted by the premier.) But in the cloud of depression, he left his job, and worried that he would never have another one.

This raises a simple question: how do you get patients like this back to work?

It seems like an obvious question to ask – and very relevant one. After all, many people with depression are off work, or have left the workforce altogether. A Towers Watson report considered disability in North America; mental health issues (typically “depression, anxiety and stress”) contribute to 78% of short-term and 67% of long-term disability claims in Canada. Let’s put that in perspective: for short-term disability, cancer was well under half that.

Yet if the burden of illness is great, little has been written about interventions to get patients with depression back to work. A 2008 Cochrane review identified only 11 randomized controlled trials (RCTs) on interventions aimed at reducing work disability in workers with major depressive disorder (and just four studies including work functioning as an outcome measure). A more recent Cochrane review considered 13 randomized controlled trials; only three studies, for example, looked at antidepressant therapy.

That’s why this week’s Reading is so interesting. “Gains in employment status following antidepressant medication or cognitive therapy for depression” by Jay C. Fournier et al. compares drug management with psychological interventions (CBT). Continue reading

Reading of the Week: Can Crowdsourcing Treat Depression?

April 23, 2015 /

Social networks aspire to connect people, which is a noble but naive goal. When we uncritically accept connection as a good thing, we overlook difficult, important questions: Are some forms of virtual communication more nourishing than others? Might some in fact be harmful? Is it possible that Facebook, for instance, leaves some people feeling more lonely? No one knows for sure. We tend to build things first and worry about the effects they have on us later.

Robert Morris is taking the opposite approach. Starting with the desired effect of helping people deal with depression, he developed Panoply, a crowdsourced website for improving mental health.

So begins this week’s Reading.

This is not your typical selection. Though the disease discussed is depression, the treatment involves social networks, not sertraline. The article is well written, but it doesn’t appear in the pages of World Psychiatry but Wired. The article details therapy, but with a focus on apps, not Adler. CBT is important, but crowdsourcing is talked about more than cognitive distortions.

Welcome to psychiatry in the 21st century.

Continue reading