Tag: mandated treatment

Reading of the Week: Coffee & Dementia Risk – the New JAMA Paper; Also, Mental Healthcare and Till on Her Son & His Illness

February 19, 2026 /

From the Editor

Many of us enjoy drinking coffee before a busy afternoon clinic. Is that cup of java actually healthy? Do caffeinated beverages like coffee and tea reduce the risk of dementia?

Smaller studies have suggested that they do reduce risk; a meta-analysis of coffee drinkers had a similar finding. In an impressive, new JAMA paper, Yu Zhang (of Harvard University) and his co-authors attempt to answer these questions. They report on a prospective cohort study involving almost 132 000 people, looking at dementia risk with a follow-up period up to 43 years. They found a reduction of about 18%. “Greater consumption of caffeinated coffee and tea was associated with lower risk of dementia and modestly better cognitive function, with the most pronounced association at moderate intake levels.” We consider the paper and its implications.

A cup (or two) a day keeps the doctor away?

It’s the paradox of modern psychiatry. Our medications and therapies have never been better, yet access remains poor and quality is uneven, in part because there is no mental health “system.” So, what can be done? In the second selection, from the podcast series Quick Takes, I sit down with Dr. Paul Kurdyak. In addition to being the longest serving ED psychiatrist at CAMH, he is the Vice-President, Medical, of Ontario Health’s Mental Health and Addictions Centre of Excellence. “Good systems just work. They don’t need to be navigated.”

And in the third selection, Madeline Till, a psychotherapist, writes about the struggles of her son, who has schizophrenia. In a New York Times essay, she wonders whether it would be easier if he had cancer. “More than anything else I have ever wanted, I want to stop this revolving door. I want schizophrenia to be treated with the same urgency, seriousness and continuity as any other life-threatening illness.”

DG

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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)

April 27, 2023 /

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.”

DG

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