Tag: Goldbloom

Reading of the Week: Guest Contribution – Dr. David Goldbloom on Lithium and Self Harm

From a Contributing Editor, Colleague and Friend of the Editor

Sixty-seven years ago, Australian psychiatrist John Cade published his case series on manic patients treated with lithium – truly the dawn of the modern era in psychopharmacology. Two decades passed before lithium came to Canada, and almost three before it came to the United States. In the treatment of mania, it was the first significant drug alternative to the only other enduring treatment from that time – electroconvulsive therapy.

Dr. John Cade (and Lithium)

Today, however, lithium suffers from under-promotion (there is no money to be made on it by the pharmaceutical industry) and under-exposure in the training of residents despite the evidence of its benefit that continues to emerge.

Here is a new paper that looks at suicide and self-harm during maintenance treatment of people with bipolar disorder treated with lithium, valproate or the increasingly popular second-generation antipsychotic drugs. And here is an old paper that reminds us what a difference lithium had already made in the economics of mental illness by 1980.

– David Goldbloom, OC, MD, FRCP(C) Continue reading

Reading of the Week: The Suicidal Doctor

From the Editor

In December, the Readings included the Mata et al. paper from JAMA considering depression and residents. The review – which included more than 50 papers – found that the prevalence of depression or depressive symptoms among resident physicians was 28.8%.

Dr. David Goldbloom’s comment on the paper is worth repeating: “it is a sobering reminder that the white coat is not Kevlar against the illnesses we treat, and our professional culture still has a long way to go in recognizing, accepting and supporting that we get sick, too.”

This week we look again at physicians and mental health. The first selection is an essay by a doctor in which he discusses his suicidal thoughts. Then, with an eye on practical interventions to help doctors at risk, we consider the JAMA Psychiatry study on CBT for interns (with a modern twist).

DG Continue reading