Tag: exercise

Reading of the Week: An Exercise App for Burnout – the New JAMA Psych Paper; Also, Pandemic Mental Health Use and Szalavitz on Portugal

From the Editor

A recent CMA survey found that more than half of physicians report high levels of burnout; surveys of other health care disciplines show a similar result. Not surprisingly, burnout is much discussed. What can be done for health care workers?

In the first selection, Vincent Gosselin Boucher (of the University of British Columbia) and his co-authors consider that question, offering an app-based intervention featuring exercises that can be done at home. The resulting study, just published in JAMA Psychiatry, included 288 health care workers in an RCT. “[A] 12-week app-based exercise intervention yielded significant reductions in depressive symptoms among HCWs that became more pronounced as time progressed.” We review the paper and its implications.

In the second selection, Jonathan H. Cantor (of the RAND Corporation) and his co-authors look at mental health utilization and spending before and during the pandemic, drawing on almost 1.6 million mental health insurance claims in the US. “[U]tilization and spending rates for mental health care services among commercially insured adults increased by 38.8% and 53.7%, respectively, between 2019 and 2022.” 

Finally, in the third selection, author Maia Szalavitz writes about the decriminalization of low-level drug crimes in Portugal. In a New York Times essay, she argues that critics don’t understand what Portugal accomplished – and, in contrast, how many Americans go untreated in correctional facilities. She concludes: “Shifting priorities and funding to provide high-quality treatment and other supports for recovery like housing takes time. Our failure is a century of criminalization – not much-needed attempts to end it.”


Continue reading

Reading of the Week: Depression and Its Management — The American Journal of Psychiatry on Exercise and Long-term Use of Medication

From the Editor

It’s one of the most common and disabling illnesses. But how to treat depression in the long term?

In the first selection, we consider a paper just published by The American Journal of Psychiatry. In it, LaSalle University’s Felipe B. Schuch and his co-authors present a meta-analysis on exercise and depression. Drawing on 49 studies, they find that physical activity can protect against the development of depression, regardless of age and geographical region.

treat-alternative-exercise_an_alternative_adhd_treatment-article-3280a-man_running_sunset-ts_451886305-3Exercise: good for the heart, the lungs, and the prevention of depression?

In the second selection, Harvard University’s Roy H. Perlis writes a commentary for The American Journal of Psychiatry responding to a recent New York Times article that questioned the long-term use of antidepressants. He writes: “The informative analogy might be treatment of type 2 diabetes. While diet and exercise have a substantial impact on disease course (notably, results far more compelling than those in depression), it is hard to envision front-page articles in the New York Times about the dangers of long-term diabetes treatment.”


Continue reading

Reading of the Week: Depression and Primary Care (Depression: Week 2 of 3)

Depression is a common psychiatric disorder and a major contributor to mortality and morbidity worldwide. Over the past decade in Sweden, work absence because of mental ill health has risen markedly and depression is a major factor. Substantial societal costs are associated with the disorder, which affects up to 15% of the population at any one time and tends to be recurrent. There are compelling reasons to investigate alternative treatments for depression. Although effective treatments exist, most people with the disorder never seek professional help. Among those that do, only half appear to benefit. Adherence with medication is often poor and waiting times for cognitive–behavioural therapy (CBT) can be lengthy, resulting in more entrenched symptoms and a worse long-term prognosis. As general medical practitioners are frequently the main care providers for depression, treatment options that are non-stigmatising, have few side-effects and can readily be prescribed in community healthcare settings are needed.

So begins a new paper that considers depression treatment in Sweden. These issues sound very familiar. Reading over this list of problems – the burden of illness, the inaccessibility of care, etc. – we could replace Sweden with Canada. And that’s why this paper is so relevant to us.

This week’s Reading: “Physical exercise and internet-based cognitive–behavioural therapy in the treatment of depression: randomised controlled trial” by Mats Hallgren et al., which was just published in the British Journal of Psychiatry.

Mats Hallgren

A quick summary: this is a smart paper seeking ways to improve the treatment of depression in the primary care setting. How to achieve better results? Hallgren et al. consider exercise and Internet-based CBT, and compare such interventions to the usual care. Continue reading