Tag: MBCT

Reading of the Week: Ten Great Papers; Also, Mindfulness’s Untapped Potential (JAMA Psych) and the FDA Approves an Antipsychotic (Nature)

From the Editor

It’s the 10th anniversary of the Reading of the Week. The program has grown and evolved over this past decade, now reaching psychiatrists and residents internationally, but the core idea – timely summaries of the latest in the literature coupled with commentary – hasn’t changed. To mark the anniversary, we look at some important papers that we have covered in the past ten years.

Last week: ten papers that I think about often (and helped change my clinical work).

This week: ten papers that I think about often (and helped change the way I view mental illness).

*      *      *

In the second selection, Jesus Montero-Marin (of the University of Oxford) and his co-authors consider mindfulness-based cognitive therapy in a new Viewpoint for JAMA Psychiatry. Noting the burden of depression, they see this therapy as being helpful, especially for those with “entrenched” depression. “By leveraging translational science, we can enhance access, engagement, and treatment outcomes for depression. This work uses MBCT as a foundational case study and delineates future research directions with the potential to profoundly impact service design and policy.”

And in the third selection, journalist Elie Dolgin reports on the new FDA-approved schizophrenia medication for Nature. He describes the novel mechanism of action and quotes Christoph Correll (of Hofstra University): “This will be a revolution of the treatment of psychosis, and I’m not saying this lightly. Now we will now be able to treat people who haven’t been helped with traditional antipsychotics.”

DG

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Reading of the Week: Battling The Black Dog

From the Editor

This week, hundreds of thousands of Canadians will not go to work because of mental health problems, depression being the most common.

But despite the long shadow cast by depression on our society, it’s difficult not to feel that we fall short in terms of our active management. Many people struggle with their symptoms; even when they can beat the “black dog” – to use Winston Churchill’s term – they are at high risk for relapse.

Can we do better with the black dog?

Here are two papers that look at bettering outcomes.

In the first, the authors ask if mindfulness can prevent the relapse of depression. The second paper considers the use of statins to improve the effects of antidepressants.

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Reading of the Week: Zen or Zoloft? Mindfulness vs. Meds for Relapse Prevention in Depression

Depression typically has a relapsing and recurrent course. Without ongoing treatment, individuals with recurrent depression have a high risk of repeated depressive relapses or recurrences throughout their life with rates of relapse or recurrence typically in the range 50–80%.

So begins this week’s Reading (which is attached). As is so often the case, the journal writing is understated.

50-80%. Wow.

Having been in practice for some years, many stories come to mind when considering this statistic.

Here’s one: a young woman with a challenging childhood who pulled her life together, kept an unplanned pregnancy, and then tried to do everything right for herself and her daughter. In her late 20s, she fell into a deep depression, attempted suicide, and had a long admission. And, after work on the inpatient unit and in the outpatient department, she returned to her life: free of symptoms, working full time, raising her daughter. Feeling well, she stopped her citalopram, and became sick again (and with an employer keen on her termination because – and this sounds like a 19th century novel – “she told me I look dead on the outside”).

It’s easy to say that she should have stayed on her medications. But many of our patients don’t. The reasons vary – the side effects are too strong, the concept of medications is unappealing, etc. – but the end result is so often the same.

What then are non-medication options for maintenance in patients with depression? This week’s Reading offers an interesting answer: mindfulness-based cognitive therapy.

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