Tag: Journal of Affective Disorders

Reading of the Week: Self-stigma & Depression – the new JAD Study; Also, ChatGPT & Mental Health Care, and Dr. Catherine Hickey on the Opioid Crisis

From the Editor 

Depression is the result of character weakness. So explained my patient who had a major depressive disorder and hesitated to take medications.

Though fading, stigma about mental illness continues to exist, including self-stigma, the negative thoughts and beliefs that patients have about their own disease – as with my patient. How common is self-stigma? How does its prevalence differ around the globe? What are risk factors for it? Nan Du (of the University of Hong Kong) and co-authors attempt to answer these questions in a new Journal of Affective Disorders paper. They do a systematic review and meta-analysis of self-stigma for people with depression, drawing on 56 studies with almost 12 000 participants, and they a focus on international comparisons. “The results showed that the global prevalence of depression self-stigma was 29%. Levels of self-stigma varied across regions, but this difference was not significant.” We consider the paper and its clinical implications.

In this week’s second selection, we look at ChatGPT and mental health care. Dr. John Torous (of Harvard University) joins me for a Quick Takes podcast interview. He sees potential for patients – including making clinical notes more accessible by bridging language and knowledge divides – and for physicians, who may benefit from a more holistic differential diagnosis and treatment plan based on multiple data sets. He acknowledges problems with privacy, accuracy, and ChatGPT’s tendency to “hallucinate,” a term he dislikes. “We want to really be cautious because these are complex pieces of software.” 

And in the third selection, Dr. Catherine Hickey (of Memorial University) writes about the opioid crisis for Academic Psychiatry. The paper opens personally, with Dr. Hickey describing paramedics trying to help a young man who had overdosed. She considers the role of psychiatry and contemplates societal biases. “[I]n a better world, the needless deaths of countless young people would never be tolerated, regardless of their skin color.”


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Reading of the Week: Running vs SSRIs for Depression – the new JAD Paper; Also, Climate Change & Mental Health, and Understanding My Schizophrenia

From the Editor

“Go for a Run to Beat Depression – It’s Just As Effective As Taking Medication”

– New York Post

“Running could be just as effective at treating depression as medication, scientists find”

– The Independent

Patients often ask what they can do to get better from their depression. Should we be advising them to put on a pair of runners and go for a jog? A new paper published in the Journal of Affective Disorders seems to suggest as much – and it’s caused a bit of media buzz. In the first selection, Josine E. Verhoeven (of Vrije Universiteit Amsterdam) and her co-authors describe this 16-week study that offered 141 people with depression and/or anxiety either a running intervention or medications, and looked at several mental and physical health outcomes. “We showed that while antidepressant medication and running therapy did not statistically significantly differ on mental health outcomes… the interventions had a significantly different and often contrasting impact on several physical health outcomes, with more favorable outcomes for those in the exercise intervention.” We consider the paper and its implications.

In the second selection, Pim Cuijpers (of Vrije Universiteit Amsterdam) and his co-authors discuss climate change and mental health in a new viewpoint for JAMA Psychiatry. Though they note the lack of high-quality research in the area, they argue that it would disproportionately affect low and middle-income nations. They then point a way forward. “There is no doubt that climate change will have a major impact on mental health in the coming decades.”

And in the third selection which is written anonymously, a person with schizophrenia talks about his experiences in a paper for Schizophrenia Bulletin. He tries to empower himself, working to limit side effects and cope with the voices. “My brain disease is incurable, but it is not an excuse for me to be irresponsible or to give up on life.” 


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Reading of the Week: Bipolar & Med Adherence – the New Journal of Affective Disorders Study; Also, Sleep (QT) and Sheff on Involuntary Treatment (NYT)

From the Editor

You wrote a prescription, but did he actually take the medications? For those with bipolar disorder, pharmacotherapy is an essential part of care. Studies have noted poor adherence. 

To date, though, there hasn’t been a big cohort study. And there are good questions to ask: what drugs are more linked with adherence? Who is more likely not to take the medications? In a new paper just published in the Journal of Affective Disorders, Dr. Jonne Lintunen (of the University of Eastern Finland) and his co-authors attempt to answer these questions. They draw on Finnish data, covering more than three decades and including over 33 000 patients. “The majority of patients with bipolar disorder do not use their medications as prescribed.” We consider the paper and its clinical implications.

In the second selection, Dr. Michael Mak (of the University of Toronto) comments on sleep in a new Quick Takes podcast interview. In this sleep “update,” we talk about meds, CBT, and the mobile apps that he recommends to patients and their families. We also explore the history of sleep medicine and mull the growing role apps and wearables are playing in both diagnosis and therapy. “The lines between sleep, health, and mental health in general are blurred.”

In the third selection, author David Sheff talks about his son’s addiction and recovery – and involuntary treatment. In a New York Times’ essay, he notes the challenges of engaging those with substance problems. He sees several ways forward, including involuntary treatment. “Many people in the traditional recovery world believe that we must wait for people who are addicted to hit bottom, with the hope that they’ll choose to enter treatment. It’s an archaic and dangerous theory.”


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Reading of the Week: Aromatherapy for Insomnia? Also, Ramadan and Mental Health and Responding to Vaccine History

From the Editor

“Sleep is one of the indispensable needs of human beings and is essential for maintaining physical and mental health.”

So writes Yueheng Tang (of the Huazhong University of Science and Technology) and co-authors in a new paper on insomnia. That topic is always relevant; with a third wave and the ongoing stresses of the pandemic, more people than ever seem to be struggling with insomnia. In the past few weeks, I’ve received a flurry of questions from patients and non-patients about remedies for insomnia.

What to make of aromatherapy? It’s trendy – but is it evidence based? In a new paper for the Journal of Affective Disorders, Tang et al. consider aromatherapy which “has a long history in China, and it has been used to strengthen the body and treat diseases since ancient times.” They conduct a meta-analysis, drawing on sixteen articles. They find: “Aromatherapy has a significant effect on improving sleep quality.” We consider the paper and ask: should we recommend this to our patients?


In the second selection, we look at a new podcast that explores Ramadan and its clinical implications. In this Quick Takes episode, I’m joined by Drs. Juveria Zaheer and Zainab Furqan (both of the University of Toronto). They discuss fasting, mental disorders, and offer some suggestions. For example, with drug regiments: “if a medication is dosed twice daily, we can ask if it can be given safely during the interval when the interval between doses is shortened? So can we give it then in the evening or at dawn and then at sunset again? Or can we give it as one dose? And we need to think about the side effects of the medication.”

Finally, in our third selection, a reader writes us. Dr. Suze G. Berkhout (of the University of Toronto) responds to the paper by Drs. Angela Desmond and Paul A. Offit considering the history of vaccines. “The story the authors tell is history as it is written by the victors: emphasizing the hard work and successes of scientists, while failing to acknowledge the ways in which vaccine technologies have also been part of an exclusionary politics of biomedicine.”

Note that there will be no Reading next week.


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Reading of the Week: A Century After Osler, Is He Relevant (NEJM)? Also, AI & Diagnosis (CMAJ) and Ketamine & Safety (JAD)

From the Editor

A century after his death, is Dr. Osler still relevant?

This week, there are three selections. First, we start with a look back with an essay on Dr. William Osler. We then look forward: with papers on AI and ketamine.

In the first selection, Drs. Charles S. Bryan (the University of South Carolina) and Scott H. Podolsky (Harvard University) write in The New England Journal of Medicine about Dr. Osler on the 100th anniversary of his death. Contemplating his life and views, they note that he “gave physicians what certain national historians gave their countries: warm feelings of togetherness, pride, and purpose.”

nlc012022-v6William Osler

In the second selection, we look at a CMAJ paper. Considering AI and health care, University of Strasbourg’s Dr. Thierry Pelaccia and his co-authors write about the reasoning of mind and machine. They see a bright future: “AI can assume its place as a routine tool in medical practice.”

Finally, for the third selection, we consider a new paper on ketamine and safety from the Journal of Affective Disorders. Drawing on several studies, NIMH’s Elia E. Acevedo-Diaz and her co-authors conclude: “The results indicate that a single intravenous subanesthetic-dose ketamine infusion was relatively safe for the treatment of [treatment-resistant depression].”


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Reading of the Week: Suicidal? Get a Postcard. The New JCP Paper on Suicide Prevention. Also, Ketamine & Inpatients

From the Editor

Can we do better at suicide prevention?

In recent years, several studies have tried brief contact interventions – that is, interventions aimed at maintaining a post-discharge connection – reporting success. These interventions have been relatively simple, such as handwritten postcards or phone calls for people post-attempt.

In this week’s selection, we look at a new paper from The Journal of Clinical Psychiatry. Involving 23 emergency departments and crisis centres in France, the authors pulled together different interventions, coming up with an algorithm offering patients care informed by the best evidence. So some patients received calls, but others were given crisis cards.

It’s an ambitious project. Did it work? The results weren’t statistically significant.

p1110389Postcards: colourful and pretty – and life-saving?

We consider this paper, the negative result, and ask: what does this say about suicide prevention? And then, looking at the evolving literature on suicide, we briefly consider a paper written by Sunnybook’s Mark Sinyor that uses IV ketamine for suicidal thoughts.

Please note: there will be no Reading next week.

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