Tagmental illness

Reading of the Week: Are Those with Mental Illness at More Risk of COVID? Also, a Podcast on Apps (QT) and Horton on Advocacy & Doctors (Macleans)

From the Editor

Are people with mental illness more likely to contract COVID-19? Are they at greater risk of dying?

With the pandemic in its eighth month, we think we have answers to these questions, but data is lacking. In the first selection, we consider a new paper, just published in World Psychiatry. QuanQiu Wang (of Case Western Reserve) and her co-authors analyzed a nation‐wide database of electronic health records of 61 million American patients, aiming to assess the impact of mental illness. “These findings identify individuals with a recent diagnosis of a mental disorder as being at increased risk for COVID‐19 infection, which is further exacerbated among African Americans and women, and as having a higher frequency of some adverse outcomes of the infection.”

coronavirus-covid-19-updates-for-canadians

In the second selection, we consider a new podcast discussing digital tools. I talk with Dr. John Torous (of Harvard University). We discuss apps and mental health. And, yes, he has tips on how to pick apps for your patients and their families.

Finally, in the third selection, we look at a new essay by Dr. Jillian Horton (of the University of Manitoba). Should doctors “stay in their lanes?” She argues against the idea, championing a new activism. “So, to my brothers and sisters in medicine: forget about staying in our lane. This is our call to flood the freeways. We cannot stay parked in neutral. There is no more time.”

Please note: there will be no Reading next week.

DG

Continue reading

Reading of the Week: Mental Illness & Crime Victimization – the New JAMA Psychiatry Paper

From the Editor

After the mass shooting on Toronto’s Danforth, mental illness has been much in the news. The Canadian Psychiatric Association went so far as to warn against stigmatizing those with mental illness.

Despite stereotypes, studies show that people with mental disorders are more likely to be victims of violent crime rather than perpetrators. That said, the literature is light on how much crime patients experience, and the diagnoses of these patients.

This week, we look at a new paper just published by JAMA Psychiatry. Drawing on databases from Denmark, the University of New South Wales’ Kimberlie Dean and her co-authors consider crime (including violent crime) in a cohort study involving more than two million people. What do they find? Those with mental illness are much more likely to be victims than the general population.

gettyimages-126140612_superDenmark: old buildings and not-so-old data

In an accompanying editorial, Duke University School of Medicine’s Jeffrey W. Swanson and Charles M. Beldendiscuss the paper, and contrast it with American data. Their piece begins memorably: “The media-driven notion that mentally ill people pose a danger to others appears to be encrusted like a barnacle on the concept of mental illness submerged in the public mind.” They also weigh in on difference in rates of violence between Denmark and the United States.

DG

 

Continue reading

Reading of the Week: Can Computerized CBT Help People with Substance Problems? The New AJP Paper. Also, How Many People Really Have Mental Illness?

From the Editor

More than ever, we are talking about substance use problems. But as with other mental health services, people struggle to get care, particularly evidence-based therapies.

In the first selection, we consider a new paper from The American Journal of Psychiatry, published last week. Yale University’s Brian Kiluk and his co-authors compare traditional CBT (done with a therapist and in-person) with a computer-based therapy program, CBT4CBT. They conclude: “This computerized version of CBT thus appears to be an engaging and attractive approach for persons with substance use disorders.”

typingTyping to Treat Substance Use?

In the second selection, we consider an essay by The Globe and Mail’s André Picard who asks a simple question: How many people actually suffer from mental illness? Picard cautions us on “pathologizing normal emotions.”

DG

Continue reading

Reading of the Week: Cancer and Mental Illness

From the Editor

“Now that I’m done with my [cancer] treatment, I’m struggling to figure out who I am,” writes essayist Suleika Jaouad.

This week’s Reading focuses on cancer and mental illness.

We open with a major new paper just published by JAMA Oncology (involving hundreds of thousands of cancer patients) and we then consider an essay by Suleika Jaouad talking about how cancer affected her physical and mental health.

DG Continue reading

Reading of the Week: Psychiatry’s Dirty Little Secret?

Stigma has repeatedly been identified as a major barrier to help seeking for mental health problems across various disorders and across the lifespan. Stigma is also an obstacle to community reintegration and rehabilitation in people suffering from severe mental illness. Moreover, people with psychiatric diagnoses suffer the effects of discrimination in health care settings. Not only do people with mental illness have diminished access to primary care, there is evidence to suggest that physicians perform fewer physical examinations and laboratory investigations, provide less preventive health care, and undertake fewer therapeutic interventions in this population. Researchers are increasingly framing the problem of stigma as a public health issue.

So begins a new paper that considers stigma and mental health.

This week’s Reading: “Explicit and Implicit Attitudes of Canadian Psychiatrists Toward People With Mental Illness” by Dr. Layla Dabby et al., which was just published in The Canadian Journal of Psychiatry.

This paper shows that members of the public demonstrated relatively negative explicit attitudes towards mental illness. In fact, Canadians reported a desire for greater social distance from the patient with schizophrenia as opposed to the patient with diabetes, even though the study describes the patient with schizophrenia as well-controlled by medication. Wow.

Except here’s the twist in the tale. The paper actually didn’t look at the public. The paper looked at psychiatrists and residents of psychiatry. In other words, the relatively negative explicit attitude wasn’t from the uninformed small businessman in Edmonton or the teacher in Halifax; it reflects the biases of people like… me.

Is this psychiatry’s dirty little secret? Continue reading

Reading of the Week: Economics and Mental Illness

For John Mooney, it was a career highlight. In March the Irish cricketer took a crucial catch that gave his team the victory in a World Cup match and eliminated the higher-ranked Zimbabwe. But afterwards the Zimbabwe Herald, a daily paper with links to Zanu-PF, the thuggish ruling party, claimed that Mr. Mooney had lied when he said that his foot had not been touching the boundary, meaning the catch should have been disallowed. The article cited previous interviews in which the sportsman had spoken frankly about his long battles with drink, depression and suicidal thoughts. Under pressure, it claimed, a “man of such a character” could not be trusted to have “the honesty, let alone the decency” to tell the truth.

John Mooney, cricketer, Ireland “player of the year” (2010), and a man with depression

So begins this week’s Reading.

The essay provides an excellent summary of the impact of mental health on our society and our economy. It also notes reasons for hope. Indeed, Mr. Mooney’s story is moving: after the Zimbabwe Herald attack, fearing that others may be reluctant to talk about their mental illness in light of his harassment, Mr. Mooney chose to publicly speak about his battle with depression. The article notes:

The reaction was heartening. Messages and thanks are still coming in.

This essay is readable and concise. “Out of the shadows: The stigma of mental illness is fading. But it will take time for sufferers to get the treatment they need” is a must read. Here’s the surprise: it was published in an economics magazine.

Welcome to 2015, where thoughtful analysis on mental health issues isn’t just for the psychiatry journals anymore. Continue reading