From the Editor
The tone of our voice when discussing a treatment. The way we emphasize its benefits. Mention of our hopefulness. As clinicians, we are aware that small things can improve patient outcomes. To speak more technically: we harness placebo effects.
In an impressive new Lancet Psychiatry review, Dr. Matthew J. Burke (of the University of Toronto) and his co-authors examine placebo effects with an eye to the implications for clinical practice. They discuss imaging and physiology; they also mention depression and offer suggestions (including, yes, harnessing placebo effects). “The thoughtful application of placebo and nocebo effects has promise in enhancing patient care and treatment outcomes, but more research is needed to validate specific approaches.” We discuss the paper and its implications.

What is the survival rate after an opioid overdose? In a new research letter just published in JAMA, Dr. Robert A. Kleinman (of the University of Toronto) and his co-authors attempt to answer that question. Though they walk on a well-travelled path, they drew on data in this, the era of fentanyl. “Mortality was higher than estimates from previous research conducted prior to the widespread availability of fentanyl (5.3%-5.5%).”
And in the third selection from The Globe and Mail, Dr. Lester Liao (of McGill University) and his co-authors write about mental health campaigns. They note the unintended consequences, including overdiagnosis of disorders like ADHD and autism. “We started out with the greatest of intentions. Unintended consequences have arisen. That’s okay. We learn along the way. Now it’s time to change course.”
There will be no Reading next week.
DG
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