Tag: ethnicity

Reading of the Week: ECT – the New NEJM Review; Also, Ethnicity & Drug Overdoses (JAMA) and Neil Seeman on His Father (CMAJ)

March 10, 2022 /

From the Editor

He has tried different medications, and yet he continues to struggle. The months have turned into years. When he was last well, he worked two jobs and was physically active, hoping to run the Boston marathon one day. When I saw him, he explained that he has difficulty following the plot of a TV show. Asked if he had ever considered ECT, his eyes widened. “They still do that?”

In the first selection, we look at a new review paper on ECT from The New England Journal of Medicine. Drs. Randall T. Espinoza (of the University of California, Los Angeles) and Charles H. Kellner (of the Medical University of South Carolina) provide a concise summary of the latest evidence. They conclude: “ECT is a valuable treatment for several severe psychiatric illnesses, particularly when a rapid response is critical and when other treatments have failed.” We consider the paper and the ongoing stigma associated with the treatment.

In the second selection, Joseph R. Friedman and Dr. Helena Hansen (both of the University of California, Los Angeles) draw on American data to consider overdose deaths and ethnicity. The JAMA Psychiatry paper concludes: “In this cross-sectional study, we observed that Black individuals had the largest percentage increase in overdose mortality rates in 2020, overtaking the rate among White individuals for the first time since 1999, and American Indian or Alaska Native individuals experienced the highest rate of overdose mortality in 2020 of any group observed.”

And in the third selection, Neil Seeman (of the University of Toronto) considers the life and death of his father, Dr. Philip Seeman, the celebrated scientist who studied schizophrenia. In this CMAJ essay, he comments on dopamine and his father’s life work. And he also writes about his relationship and dying. “It was that giving ice chips to my father will forever remind me of how the sensation of touch can stir love, fetch memories, and offer solace.”

DG

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Reading of the Week: Suicide and Ethnic Groups – the New Lancet Psychiatry Paper; Also, Cannabis & the Differential (JAMA Int Med)

December 9, 2021 /

From the Editor

Discrimination. Microaggression. Stigma. Patients in ethnic groups often face greater challenges and stresses than others. Do suicide rates differ? What are the implications for interventions?

These are good and important questions, yet the literature is thin. In a new paper for The Lancet Psychiatry, Isabelle M. Hunt (of the University of Manchester) and her co-authors consider suicide rates by ethnic group in the UK, focused on those who have had contact with mental health care. Drawing on a large database, they find lower rates of suicide completions compared to White patients, but significant variation among the different groups. The authors see potential clinical implications: “Clinicians and the services in which they work should be aware of the common and distinct social and clinical needs of minority ethnic patients with mental illness.”

fd1c8d415f97df29c61ed70a727e8974The Death of Socrates – and, yes, White patients died by suicide more

In the second selection, Dr. Anees Bahji (of the University of Calgary) and his co-authors consider cannabis use disorder in a patient who presents with cannabis hyperemesis syndrome. Their JAMA Internal Medicine paper is very practical; they suggest: “a multidisciplinary approach that incorporates psychotherapy, withdrawal symptom management, and close follow-up in the primary care setting is recommended for treatment of cannabis-related harms.”

DG

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Reading of the Week: More Sleep, Fewer Suicidal Thoughts? New AJP Paper; Also, Is Depression like Cancer (NYT)? Admissions & Ethnic Minorities (EPS)

October 24, 2019 /

From the Editor

Can a sleep intervention reduce suicidal thoughts in those with depression and insomnia?

When seeing people with depression, we often tend to focus on the Big Problem: that is, the major depressive disorder itself. But should we also consider trying to provide early symptomatic relief, with, say, a sleep medication?

In the first selection, we look at a new paper from The American Journal of Psychiatry. Dr. William V. McCall of the Medical College of Georgia at Augusta University and his co-authors write about the REST-IT study, a randomized controlled trial of zolpidem-CR for those with MDD and insomnia. “The results do not support the routine prescription of hypnotic medication for mitigating suicidal ideation in all depressed outpatients with insomnia…”

sleeping-babySleeping Like a Baby: Fewer Suicidal Thoughts?

In the second selection, the University of Western Ontario’s Rebecca Rodrigues and her co-authors consider involuntary psychiatric admissions and ethnic minority groups in the context of early psychosis. Spoiler alert: “African and Caribbean groups were the most likely to experience an involuntary admission…”

And in the third selection, phyisician Jill Halper wonders: is depression like cancer? “My rabbi said that my husband, like a dying cancer patient, had been in hospice care. We just didn’t realize it.”

DG

 

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Reading of the Week: Hospitalizations and Ethnicity (and Stigma)

August 25, 2016 /

From the Editor

Younger and sicker.

This week, we look at a new paper published in The Journal of Clinical Psychiatry considering ethnicity and hospitalizations. Drawing on Ontario data, researchers looked at psychiatric hospitalizations for people of Chinese and South Asian descent, finding that they were younger and more ill at the time of admission.

Hospitalizations, ethnicity… and access

Lead author Maria Chiu of the Institute for Clinical Evaluative Sciences told the Toronto Star:

Cultural factors play a big role in these findings. While Asian people tend to have stronger family support, they are also faced with a higher level of stigma and it prevents people from seeking help early. Families may try to cope and keep the illness within the family until there is no choice but to go to hospital.

This paper is well designed. It’s also important, speaking to larger issues about access, stigma, and ethnicity.

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