Tag: Green

Reading of the Week: rTMS – the New JAMA Psych Paper; Also, Opioid Overdoses (JAMA Net Open) and Green on Peak Mental Health (NYT)

From the Editor

She’s an accomplished person who had succeeded in business and then writing, all the while raising three children; she also has an amazing smile and lights up the room when talking about her kids. But in my office, sick with depression, she can only focus on her losses and failings; the smile is absent.

Depression is common and disabling. Those who are affected in late-life are particularly challenging to treat. Is there a better way? In the first selection from JAMA Psychiatry, Dr. Daniel Blumberger (of the University of Toronto) and his co-authors consider theta burst stimulation, a newer form of rTMS which has shown promise in earlier work. Their study is a randomized noninferiority trial, directly comparing the two versions of rTMS in elderly patients with depression. The result? “We showed that bilateral TBS was noninferior to standard bilateral rTMS in improving depression, and similarly well tolerated, in a real-world sample of older adults with TRD [treatment resistant depression]…” We review the paper and its clinical implications.

In the second selection, Lori Ann Post (of Northwestern University) and her co-authors draw on CDC data to look at opioid overdoses in the United States with a focus on geography. In a JAMA Network Open research letter, they find: “Overall, opioid-involved overdose deaths rates increased steadily in counties of every urbanicity type, although there were distinct temporal wave patterns by urbanicity.”

And in the third selection, Huw Green (of the University of Cambridge) wonders about mental health and mental illness – and worries that the terms are becoming blurred together. Writing in The New York Times, the psychologist concludes: “When we move away from a focus on psychological problems and toward ‘mental health’ more broadly, clinicians stumble into terrain that extends beyond our expertise. We ought to be appropriately humble.”  

This month, the Reading of the Week enters its ninth year. A quick word of thanks for your ongoing interest.


Continue reading

Reading of the Week: How Do University Students Use Cannabis? Also, the Life and Legacy of Richard Green, and Scott Gottlieb on E-Cigs

From the Editor

I don’t quite remember when I changed my interview questions, but at some point – more than a decade ago – I stopped assuming that if I asked about street drugs, patients would tell me about cannabis. Long before legalization, people stopped seeing cannabis as illicit. Today, not only is cannabis legal for recreational use, many see it as a drug to be taken for their health.

In a new Canadian Journal of Psychiatry paper, the authors write about cannabis use for medicinal purposes among Canadian university students. Drawing on a survey, they find wide use – but not exactly the use that follows the guidelines.

We also consider two other pieces: an obituary for Dr. Richard Green, a prominent psychiatrist who challenged the DSM’s inclusion of homosexuality, and an interview with Dr. Scott Gottlieb, the outgoing FDA Commissioner, who worries about e-cigarettes.

508221091 Use – but medicinal use?

Enjoy these selections.

And an invitation: the Reading of the Week series invites guest contributions. If this is of interest to you, please let me know.


Continue reading