Tag: Doctor & Patient

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: Do ADHD Meds Reduce Mortality? The New JAMA Psych Study; Also, Dr. Rebecca Lawrence on Her Husband & His Support

From the Editor

For my patient, ADHD medications transformed his life, helping him focus at school and at work – and even drive better. Many have had similar experiences. Do ADHD medications also reduce mortality? We know that those with ADHD have higher mortality rates and thus it’s reasonable to ask about the possible benefits of methylphenidate and sister drugs.

Lin Li (of the Karolinska Institutet) and her co-authors try to answer that question in a new JAMA Psychiatry paper. Drawing on Swedish databases, they analyzed data from almost 150 000 people with ADHD and looked at two-year mortality, including for those who die by unintentional injuries, suicide, or poisonings, by doing a target trial emulsion – simulating a randomized trial. “Among individuals diagnosed with ADHD, medication initiation was associated with significantly lower all-cause mortality, particularly for death due to unnatural causes.” We consider the paper, the editorial that accompanies it, and the clinical implications.

ADHD meds: life saver?

And in the other selection, Dr. Rebecca Lawrence writes about support in a blog for Doctor and Patient. She is personal – besides working as psychiatrist, Dr. Lawrence has been treated for depression, including with ECT. She notes the incredible help her husband has given her over the years. “I look at myself in the mirror and am appalled, but he still smiles at me.

DG

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