Tag: child psychiatry

Reading of the Week: tDCS for Depression – the New JAMA Psych Paper; Also, Psychiatrists & AI and Dr. Daniel Gorman on Charlatan Syndrome

From the Editor

In her autobiography, psychiatrist Linda Gask writes about her struggles with depression and the moment she realized that she was better: she started to hear the birds chirping again. For many of our patients, the songs of the birds remain elusive. Antidepressants work but some patients don’t respond, and others are cool to the idea of medication management. CBT is effective but difficult to access. What about Transcranial Direct Current Stimulation (tDCS) – an intervention that could be done at home?

Dr. Lucas Borrione (of the University of São Paulo) and his co-authors try to answer that question in a new JAMA Psychiatry paper. They report on a randomized clinical trial including 210 Brazilian adults with a major depressive episode who were offered tDCS and a digital intervention; the study featured two sham interventions. “The findings indicate that unsupervised home use tDCS should not be currently recommended in clinical practice.” We consider the paper and its clinical implications.

Would tDCS have helped?

Artificial intelligence is having a moment. Not surprisingly, many are seeing the possibilities for mental health care, from better therapy to reduced paperwork. In the second selection, from Psychiatry Research, Charlotte Blease (of Uppsala University) and her co-authors report on the findings of a survey of 138 psychiatrists with both qualitative and quantitative data. “The foremost interest was around the potential of these tools to assist psychiatrists with documentation.”

And in the third selection, Dr. Daniel Gorman (of the University of Toronto) writes about the struggles of taking a child to Disney World in JAMA. Any parent – or aunt or cousin or older sib – can relate. But Dr. Gorman notes the particular challenges that he faces: he’s a child psychiatrist. “Sometimes I fantasize about sharing with parents my doubts about parenting strategies, but the risks always seem too great – the risk of discrediting myself and my profession and the risk of robbing parents of agency and hope.”


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Reading of the Week: Effective Therapy for Anxious & Depressed Youth in a Peds Clinic? The New Weersing Study

From the Editor

“Anxiety and depression in youth are widely prevalent, highly impairing, and woefully undertreated.”

So writes San Diego State University’s V. Robin Weersing and her co-authors in a new JAMA Psychiatry paper. In this study, they compare a pediatric clinic-based brief behavioural treatment to referral to outpatient services for depression and anxiety. It’s a novel approach – and one with significant advantages (housing treatment in a primary care setting, to name just one).

So does this work? Spoiler alert: the brief behavioural treatment (BBT) comes out on top.

Anxiety treatment in the peds office: would Norman Rockwell approve?

As an accompanying Editorial notes: “The efficacy of BBT is particularly telling given the low response rate to treatment as usual in the control condition (57% vs 28%), especially for Hispanic populations (76% vs 7%).”

Please note: there will be no Reading next week because of the APA Annual Meeting. (I hope to see you in California.)


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