Tag: Nature

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

Continue reading

Reading of the Week: Lithium vs. Newer Meds for Bipolar – What’s Best? Also, Nudging Vaccines and Beale on Her Illness Experience & Being a Doctor (BMJ)

From the Editor

In the past, lithium had a large role – in the treatment of bipolar, yes, and before that, as a general remedy for a variety of conditions. Indeed, lithium could be found in various things, including pop (see the picture of the ad for 7 Up below). But times have changed. Lithium prescriptions are less common, and bipolar management increasingly involves other medications. (And, no, 7 Up doesn’t contain that salt anymore.)

How does lithium compare to these medications for people with bipolar? Dr. Jens Bohlken (of the University of Leipzig) and his co-authors do a retrospective study drawing on a national database from Germany. “When treatment failure was defined as discontinuing medication or the add-on of a mood stabilizer, or antipsychotic, antidepressant, or benzodiazepine, lithium appears to be more successful as monotherapy maintenance treatment than olanzapine, citalopram, quetiapine, valproate, and venlafaxine.” We look at the big study, and mull its implications on this side of the Atlantic.

wxwbs-1443730637-blog-456

Can we nudge people to vaccinate? As the world works to get more shots in arms, Dr. Mitesh Patel (of the University of Pennsylvania) argues that behavioural economics will be important. In Nature, he writes that we have a golden opportunity to learn from the vaccine roll-out: “Each institution should report its vaccination efforts and performance, and conduct rapid experiments on how best to encourage people to get their vaccines – especially their second doses.”

Finally, some physicians have commented that being touched by illness has helped them become better doctors. Dr. Chloe Beale, a British psychiatrist, agrees to disagree in a blog for BMJ. “I can’t give the expected, tidy narrative of emerging stronger for having my illness.”

DG

Continue reading

Reading of the Week: Behavioural Economics & Mental Illness – the New JAMA Psychiatry Paper; Also, the Strange History of Lithium

From the Editor

Can we nudge people to better choices? Economists, psychologists, and psychiatrists have all considered this idea. Though early work looked at pensions and finance, more recent studies in behavioural economics have considered topics in health care, like helping smokers quit.

This week, we open with a new paper that considers the concept of delay discounting in people with major mental illness. “Delay discounting” is a clunky term for the value that people place on rewards over time. Take two individuals, Paul and Peter, offered the same deal: they can be given $100 today or $200 in three months – Paul wants the $100 now while Peter is willing to wait for the bigger reward of $200. Paul, then, has more delay discounting than Peter.

Existing literature shows delayed discounting for people who have addiction and ADHD diagnoses. But what about others with mental disorders? McMaster University’s Michael Amlung and his co-authors study delay discounting by doing a meta-analysis, pulling data from 43 studies involving eight psychiatric disorders in this new JAMA Psychiatry paper. “To our knowledge, this meta-analysis is the first quantitative synthesis of delay discounting findings in psychiatric disorders, except ADHD and addictive disorders. This meta-analysis provides relatively strong evidence that delay discounting is a transdiagnostic process in psychiatric disorders.”

4-nudge_elephantBehavioural economics (and nudging): different for those with mental disorders

In our second selection, we consider a longer essay on lithium for bipolar and its first champion. The University of Groningen’s Douwe Draaisma, a professor of the history of psychology, writes about urine, guinea pigs, and the beginning of the psychopharmacological era.

DG

Continue reading