Tag: JAMA Psychiatry

Reading of the Week: AI Psychosis – from JAMA Psychiatry; Also, Benzodiazepines in the US, and Dr. Belay on Social Media & Symptoms

October 15, 2026 / / 0 Comments

From the Editor

ChatGPT is the most downloaded app in history. People turn to AI for travel tips and restaurant advice. But what about its impact on those vulnerable to psychosis? Or those experiencing psychosis?

In a new research letter published in JAMA Psychiatry, Zachary Bergson (of Vanderbilt University) and his co-authors attempt to answer those questions by analyzing more than 200 000 mental health notes at an academic centre. “In this systematic analysis of AI psychosis, documented in the EHR of a large US medical setting, psychosis-worsening interactions with conversational AI were most common among patients experiencing their first episode of psychosis.” We consider the study and its implications.

In the second selection, from The American Journal of Psychiatry, Naomi Cruz (of Rutgers University) and her co-authors look at benzodiazepine dispensing in the United States, using data on 1.1 billion prescriptions. “From 2013 to 2024, the national prevalence of dispensed benzodiazepine prescriptions declined by more than one-quarter, with reductions across all patient age groups and most prescriber types as well as in the mean dose dispensed per benzodiazepine prescription.”

And in the third selection, from The Washington Post, Dr. Nebyou Belay, a psychiatrist, writes about the influence of the Internet on psychiatric diagnoses. He argues that social media can encourage people – particularly young people – to adopt psychiatric diagnoses before their symptoms have been properly assessed, blurring the line between normal distress and mental illness. “Psychiatry should help people understand what they are experiencing. Increasingly, however, the Internet gets there first.”

DG

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Reading of the Week: Cannabis – With Papers from Lancet Psych and JAMA Psych; Also, Dr. Kaliamurthy on How the Weed Got Too Strong

October 8, 2026 / / 0 Comments

From the Editor

Cannabis was the only thing that helped him sleep, my patient explained. He also described positive information he had found online. He then asked: Will it affect my psychosis?

In a new review published in The Lancet Psychiatry, Wayne Hall (of The University of Queensland) and his co-authors look at cannabis use and major mental disorders. The topic isn’t new, of course, but their approach is impressive: they draw on many types of studies (epidemiological, genetic, experimental, and preclinical) to try to establish the connection – or the lack of connection – between daily cannabis use and psychosis, bipolar disorder, anxiety, and depression. “There is credible evidence that regular cannabis use plays a contributory causal role in psychosis.” We discuss the paper and its implications.

How have cannabis and alcohol misuse changed over time? In the second selection, from JAMA Psychiatry, Beth Han (of National Institutes of Health) and her co-authors use a US dataset with almost 190 000 participants, and show a sharp rise in cannabis use disorder. “More effective cannabis use disorder treatments are needed.”

Finally, in the third selection, Dr. Sivabalaji Kaliamurthy (of Howard University) writes about cannabis in an essay for The New York Times. He notes a big increase in the potency of cannabis and describes his worries as a physician, particularly about adolescent users. “The question now is whether we are willing to regulate and enforce product safety, especially to protect the most vulnerable among us.”

DG

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Reading of the Week: Will the Doctor See You Now? Video vs In-Person Visit Outcomes; Also, Suicide Prevention in India and Barford on Fake Patients

September 24, 2026 /

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, establishing partnerships in seven countries and promotional arrangements in three more.  

A quick word of thanks for your ongoing interest.

In March 2020, mental health services were transformed by the reality of the pandemic and the webcam became indispensable. Today, many clinical programs offer a mix of video, in-person, and phone visits. But what are the outcomes?

In a new JAMA Network Open paper, Samantha L. Connolly (of Harvard University) and her co-authors attempt to answer that question. Using Veterans Affairs’ data involving 813 699 participants, they compared different modalities of care and looked at outcomes over a year, including inpatient admissions. “In this comparative effectiveness study, receiving mental healthcare via video was associated with improved clinical outcomes compared with receiving care via phone or in-person.” We consider the paper and its implications.

In the second selection, Rakhi Dandona (of the Public Health Foundation of India) and Dr. Rajesh Sagar (of the All India Institute of Medical Sciences) write about suicide prevention in JAMA Psychiatry. They offer lessons from India, where one in five suicides occur. “If most suicides occur in LMICs, then the future of suicide prevention should increasingly be shaped by evidence generated within them.”

And in the third selection from The Globe and Mail, Pat Barford writes about being a “fake patient,” to use her term. She describes her work as a standardized patient for medical students. “I get to watch the highest level of learning happen in real-time.” 

DG


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Reading of the Week: Economic Burden of Depression – the New Nature Med Study; Also, AI & Delusions and Dr. Garfinkle-Crowell on Young Women

September 17, 2026 /

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, with partnerships in seven countries and promotion in three more.  

A quick word of thanks for your ongoing interest.

We usually think about depression on the individual level – our patients tell stories of lost jobs, broken relationships, and personal tragedies. But what are the societal costs? In a new Nature Medicine paper, Zhong Cao (of Heidelberg University) and his co-authors attempt to answer that question. They analyzed World Bank data; using labour force participation, education, and work experience, they projected the global economic burden of depression to 2050. “Overall, depression places a heavy strain on the global economy, accounting for about 0.460% of the world’s annual GDP. This burden, however, is uneven across regions.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Philip R. Corlett (of Yale University) weighs in on AI and psychosis in a new commentary. Does AI cause psychosis? Does it exacerbate problems for those who are vulnerable? Corlett reviews this young literature and offers his thoughts. “I suspect that they are not merely old wine in new bottles, but rather new wine in new bottles.”

Finally, in the third selection, Dr. Suzanne Garfinkle-Crowell (of the Icahn School of Medicine at Mount Sinai) writes about therapy-speak and young women for The New York Times. She describes the trend and its implications – and warns against dismissing it. “Ideally, we should create an environment in which girls can stop blaming their own brains for every problem and where they don’t feel they have to be sick to be heard.”

DG

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Reading of the Week: Social Media Likes & Depression – the New JAMA Psych Paper; Also, Dr. Taglienti on Being Noticed

July 30, 2026 /

From the Editor

When you post a cute picture of your baby cousin on social media, you receive many likes and feel encouraged to post more. To speak technically, drawing on reinforcement learning, social rewards reinforce posting. But how do people with depression respond to social media? Would they be less motivated by reinforcement learning (consistent with past work)? Could platforms like Twitter (now X) actually worsen depression?

In a new JAMA Psychiatry study, Dan-Mircea Mirea (of Princeton University) and his colleagues attempt to answer these questions. They analyzed 17 million posts from almost 8 000 Twitter users to test the association between depression and the tendency to be reinforced by likes. “In this cross-sectional study, we found that individuals with depressive psychopathology showed a greater tendency to be reinforced by likes on Twitter.” We consider the paper and its implications; we also look at the accompanying Editorial.

And in this week’s other selection, from JAMA, Dr. Jenna Taglienti (of Hofstra University) writes about a resident who misses a call shift. As the residency program director, she thinks on their conversation – and on being noticed. She recalls the loss of her mother. “I think about my mother labeling photographs and childhood keepsakes long before any of us were ready to imagine needing them.”

DG

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Reading of the Week: Doctors & Suicidality – the New CMAJ Study; Also, GLP-1 RAs & Eating Disorders, and Chin-Yee on the Death of the Consult Note

July 9, 2026 /

From the Editor

His suicidal thoughts were so strong that he had written a suicide note. Yet, during the months before we met in the ED, he had hesitated to seek care. As a doctor, he knew he had severe depression but he told me that he felt he couldn’t get help. 

Such stories are all too common. In a CMAJ study, Dr. An Yi (Annie) Yu (of the University of Toronto) and her co-authors shed light on physicians’ seeking help for suicidality. They drew from the literature (literally): analyzing 52 narratives from academic papers, finding various barriers to seeking care, including aspects of medical culture, and identified facilitators, such as confidential services. “The pressure to achieve in medicine often discourages physicians from acknowledging their need for help, but the value of meaningful work emerged as a positive factor for mental health. The stigma regarding mental health concerns was substantially reduced through role modelling of help-seeking behaviour by colleagues.” We consider the study and its implications.

GLP-1 receptor agonists are having a moment because of the evidence for diabetes and other conditions. In the second selection, Nicholas C. Peiper (of the University of Louisville) and his co-authors focus on those with eating disorders, analyzing data to understand use and misuse in a new JAMA Psychiatry research letter. “This cross-sectional study found that GLP-1 RA use and misuse were common in a targeted sample of people with eating disorders.”

And in the third selection, from JAMA, Dr. Benjamin Chin-Yee (of Western University) writes about consult notes. He wonders what is lost in the “digital transformation” of templates and AI scribes. He worries about the future of the consult note. “The tools may evolve, but the art of pausing, thinking, and telling a story is still ours to preserve.”

DG

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Reading of the Week: Help-seeking & Gambling – the New CMAJ Study; Also, Women With Schizophrenia, and Dr. Campo on Patients & Faith

June 18, 2026 /

From the Editor

Can Argentina repeat? Could England end its six-decade drought? Roughly five billion people will watch this year’s World Cup. The tournament can be understood in different ways: a great sporting event, a giant party, and, yes, a huge draw for gamblers. In Ontario – and across North America – recent laws have dramatically expanded gambling options. How have such changes affected problem gambling and the need for help? 

In a new CMAJ study, Ryan Forrest (of the University of Toronto) and his co-authors attempt to answer that question. They drew on Ontario data to quantify the increase in help-seeking following the launch of a government-operated online gambling platform in January 2015 and the subsequent expansion of private online gambling. They analyzed almost 750 000 contacts to a helpline over 13 years, finding that the mean monthly rate of gambling-related contacts nearly doubled. “The rapid expansion and privatization of online gambling, including single-event sports betting, in Ontario were respectively associated with marked increases in gambling-related helpline contacts, specifically among adolescent boys and young men.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Laura M. Rowland (of the University of Maryland) and Dr. Ellen E. Lee (of the University of California San Diego) write about schizophrenia and women. “The lack of focused health research on women in general is well recognized, and mental health research remains no exception. Surprisingly, there is also a lack of mental health research on older people with schizophrenia with less than 5% of scientific publications on schizophrenia dedicated to this older group.”

Finally, in the third selection, Dr. John V. Campo (of Johns Hopkins University) discusses faith and psychiatry. In a personal essay for The Washington Post, he notes his own religious experience and declining health. “Taking our patients seriously requires physicians to explore issues of ultimate concern, suggesting that a spiritual history should be an expected component of any comprehensive clinical evaluation.”

DG

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Reading of the Week: Psychedelics vs Antidepressants – the New JAMA Psych Paper; Also, US Psilocybin Use and Hahn on the Work of Mental Illness

April 30, 2026 /

From the Editor

“Trump signs order to accelerate access to psychedelic drug treatments”

– Reuters, 18 April 2026

Last week, the U.S. president signed an executive order easing the way for more research on psychedelics for mental illness. It’s another example of the enthusiasm that many – policymakers, politicians, patients, families, members of the public – have for these drugs. Past work has indicated some effectiveness in treating depression. But how much of it can be explained by placebo? Psychedelics are, after all, challenging to study, in part because of difficulties with blinding (people can figure out whether they receive a psychedelic or placebo).

Dr. Zachary J. Williams (of the University of California, Los Angeles) and his co-authors attempt to shed light on this issue with a new, smart study published in JAMA Psychiatry. In it, they did a meta-analysis, comparing the effectiveness of psychedelic-assisted therapy (PAT) and open-label traditional antidepressants (TADs) for the treatment of major depression, drawing on 24 studies. “These findings suggest that PAT is no more effective than TADs under equal-unblinding conditions for the treatment of depression and highlight the potential role of blinding integrity.” We consider the paper and its implications.

And, on the topic of psychedelics, Dr. Kevin H. Yang (of the University of California, San Diego) and his co-authors look to quantify the number of people using psilocybin in the United States. In a priority data letter for The American Journal of Psychiatry, they used data from the National Survey on Drug Use and Health, a survey with more than 59 000 respondents. “With approximately 8 million individuals estimated as having used in the past year, naturalistic psilocybin use is sufficiently prevalent that psychiatrists are likely to encounter patients who use it outside of clinical settings.”

And in the third selection, an essay from The Globe and Mail, Brandon Hahn writes personally about his experiences with mental illness, noting public intolerance and tolerance – and meaningful gestures. “Sometimes support looks like red tape and a pile of forms. Sometimes it looks like a chair that faces the window while holding a hand.”

DG

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Reading of the Week: Mirtazapine for Methamphetamine – the New JAMA Psych Study; Also, Patients & AI and Delgaram-Nejad on His Meds

April 16, 2026 /

From the Editor

He occasionally used cannabis in his 20s and did not try crystal methamphetamine until after his 35th birthday. He readily admits to problematic use, undermining his relationship and leading to the loss of his job. In my office, he describes his desperation and asks: Is there a medication that could help?

In the first selection, a new paper published in JAMA Psychiatry, Rebecca McKetin (of the University of New South Wales) and her co-authors attempt to answer that question. In an impressive new study, they report the results of a phase 3, parallel-group, double-blind, placebo-controlled RCT involving 344 people with moderate or severe methamphetamine use disorder and a trial of mirtazapine or placebo. “The results of this randomized clinical trial confirm that mirtazapine can be used in routine clinical practice to facilitate a reduction in methamphetamine use among people with a moderate to severe methamphetamine use disorder.” We consider the paper and its implications.

In the second selection, Shaddy K. Saba and Dr. William B. Weeks (both of New York University) write on AI and patients. In a commentary for JAMA Psychiatry, the authors observe that an increasing number of patients are turning to AI and argue that clinicians need to become actively involved. “The question is not whether AI is good or bad for mental health: like many other patient behaviors, it can be both and depends on context. The question for clinicians is whether to help patients navigate its use.”

Finally, in the third selection from Schizophrenia Bulletin, Oliver Delgaram-Nejad – who has schizophrenia – discusses his decision to stop medication. Reviewing his episodes of psychosis, he argues that antipsychotics are too problematic for him. “I have weighed the benefits and risks, and navigated the rather painful tension, of remaining on an antipsychotic and living with the side effects versus accepting the risk of relapse and reclaiming my energy.”

DG

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Reading of the Week: Psychotic Prompts & AI – from JAMA Psych; Also, Lithium Landscape and Dr. Cooke on Growing Up

April 2, 2026 /

From the Editor

Patients, including those with psychosis, may turn to AI chatbots for advice. What are they told? And are they encouraged to seek care?

In a research letter that was recently published in JAMA Psychiatry, Dr. Elaine Shen (of Columbia University) and her co-authors attempt to answer these questions. Using three versions of ChatGPT, they provided 79 statements indicative of positive psychotic symptoms and 79 that were neutral. The responses were then rated by two reviewers. With the free version of ChatGPT – what most people use – psychotic prompts had 43-fold higher cumulative odds of receiving a less appropriate rating than control prompts. We consider the study and its implications.

Lithium has fallen out of fashion; a recent Canadian paper found declining prescriptions in Alberta. In a new American Journal of Psychiatry commentary, Dr. Robert M. Post (of George Washington University) and his co-authors make the case for the old mood stabilizer. They offer several arguments, including that it is a disease-modifying agent. “Clinicians, patients, and the public should be educated about the unique assets of lithium, such that conventional treatment paradigms of bipolar disorder emphasize the greater and earlier use of the drug to achieve a more benign course of illness and less cognitive dysfunction.”

Finally, in the third selection from JAMA, Dr. Emma M. Cooke (of Harvard University) writes about medical school rotations. Now an internist, she remembers the common med school question: “what do you want to do when you grow up?” She mulls her responses – and the simplicity of the question. “For everyone in medicine, not just medical students, our choice of specialty is just a single data point in what makes us who we are.”

DG


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