Tag: Husain

Reading of the Week: Culturally-Adapted CBT for Postnatal Depression – the New Lancet Study; Also, ADHD in Adults (JAMA Psych) and the Latest in the News

From the Editor

She was offered CBT through our outpatient program. Though we encouraged her to come, she didn’t even attend one session. Was the problem partly with the rigidity of our program which wasn’t tailored to her cultural background or language? Can we do better? 

Dr. Nusrat Husain (of the University of Manchester) and his co-authors attempt to answer these questions in a new RCT published in The Lancet. In their study, British south Asian women with postnatal depression were randomized to a culturally-adapted form of CBT or treatment as usual. “Participants in the [intervention] group were estimated to be almost twice as likely to have recovered at 4 months than those in the control group.” We consider the paper, the accompanying Comment, and the implications for clinical care.

In the second selection, Drs. Carlos Blanco (of the National Institutes of Health) and Craig B. H. Surman (of Harvard University) write about ADHD for adults. In a new JAMA Psychiatry Viewpoint, they argue that more needs to be done, especially given the adverse outcomes of untreated ADHD. “A tension exists between undertreatment of adults with ADHD and overuse of addictive treatments for the condition.”

Finally, we explore the latest news with recent articles from The Washington PostThe Globe and Mail, and The New York Times. The topics: ChatGPT for psychotherapy, the generosity of Bruce McKean, and the street psychiatry in LA.

DG

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Reading of the Week: Amphetamines & ED Visits – the New CJP Paper; Also, Psilocybin for Depression (QT) and Anti-NMDAR Encephalitis (CMAJ)

From the Editor

Agitated, excited, violent – when intoxicated. But my patient is also pleasant and engaging when not using substance (crystal methamphetamine).

Amphetamine use seems more and more common. What does the data show? In a new paper for The Canadian Journal of Psychiatry, James A. G. Crispo (of the University of British Columbia) and his co-authors look at amphetamine-related ED visits in Ontario. Drawing on administrative databases, they find a sharp rise over time: a 15-fold increase between 2003 and 2020. They write: “Increasing rates of amphetamine-related ED visits in Ontario are cause for concern.”

In the second selection, Dr. Ishrat Husain (of the University of Toronto) comments on psilocybin and depression in a new Quick Takes podcast. He goes into detail on the new NEJM study – which he co-authored. Dr. Husain discusses the literature and unanswered research questions. “It’s not necessarily all sunshine and rainbows.”

And in the third selection, Dr. Candace Marsters (of the University of Alberta) and her colleagues consider the unusual presentation of young adult with first-episode psychosis in a new paper for CMAJ. With time and diagnostic testing, they conclude that she has anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, and offer observations about that diagnosis and the limitations of testing. “Anti-NMDAR encephalitis is a rare but important differential diagnosis of first-episode psychosis among young adults.”

DG

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Reading of the Week: Psilocybin for Depression – The New NEJM Paper

From the Editor

Is this the breakthrough we have been waiting for?

This week, we look at the new study from The New England Journal of Medicine considering psilocybin (a naturally occurring psychedelic compound found in some mushrooms) and escitalopram for depression. The paper, written by Robin Carhart-Harris (of Imperial College) and his co-authors, has received much attention. One online news source quipped: “Tripping may be as effective as your antidepressants.”

In this study, psilocybin was compared to the SSRI with a double-blind, randomized, controlled trial. Carhart-Harris et al. find: “On the basis of the change in depression scores on the QIDS-SR-16 at week 6, this trial did not show a significant difference in antidepressant effects between psilocybin and escitalopram in a selected group of patients.”

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We consider the paper and the editorial that runs with it by Dr. Jeffrey A. Lieberman (of Columbia University). We also ask Dr. Ishrat Husain (of the University of Toronto) for his thoughts. Finally, we mention other cutting-edge treatments.

DG

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