Tag: outcomes

Reading of the Week: Does COVID Affect Outcomes? Also, Depression & Behavioural Economics (JAMA Psych), and Crawford on Virtual Care (Walrus)

From the Editor

As we head into the second wave, are there lessons from the spring?

This week, we have three selections.

In the first, published in The Lancet Psychiatry, Dr. Seung Won Lee (of the Sejong University College of Software Convergence) and co-authors look at mental illness and COVID-19 in South Korea. Doing a cohort study, drawing on national databases, they wonder about diagnosis and clinical outcomes for those with mental illness. “Diagnosis of a mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2.” It’s a big finding – but is it relevant on this side of the Pacific?

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Can we nudge patients with depression to take medications? In the second selection, we look at a new JAMA Psychiatry research letter. Steven C. Marcus (of the University of Pennsylvania) and his co-authors offer financial incentives for medication compliance. They conclude: “In this pilot study, escalating incentives for daily antidepressant adherence significantly improved adherence compared with a control group during the critical first 6 weeks of treatment.”

Finally, in our third selection, we consider an essay by Dr. Allison Crawford (of the University of Toronto) from The Walrus. She writes about the change in mental health care with COVID-19, as virtual care has become the norm. “I take off my shoes so that I can enter softly and with an open heart. My patients can’t see my bare feet.”

DG

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Reading of the Week: Too Few Psychiatrists? Anderssen on the Gap in Access (Globe); Also, Cuijpers on Success in Depression Treatment (Expert Review)

From the Editor

After a break, the Readings are back. In the coming weeks, we will consider important papers on depression treatment, cannabis, help for the homeless, and more.

This week, there are two selections.

In the first selection, we consider the new Globe and Mail essay by reporter Erin Anderssen on the supply (or the lack of supply) of psychiatrists across Canada. This essay does a sparkling job of pulling together stories and reports, and includes an overview of the literature. It paints a familiar, if unsettling, picture of need unmatched by availability, and includes interviews and original data analysis.

She writes: “The modern psychiatrist can’t be everywhere. So they should be where Canadians need them most.”

We summarize the essay and some of the larger questions raised.

anderssenErin Anderssen

In the second selection, the Vrije Universiteit Amsterdam’s Pim Cuijpers writes about depression and treatment. Thinking about successful care, he asks a simple question: “When patients seek treatment, is a reduction of depressive symptoms really what they want, or do patients have other goals as well?”

DG

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Reading of the Week: Mental Health Care – Doing Bad, Feeling Good? The Hayes et al. Study

From the Editor

Greetings from Ottawa. This morning, the Canadian Psychiatric Association’s 67th Annual Conference opens here. And the agenda looks great, and includes the release of the new Canadian guidelines for the treatment of schizophrenia.

It’s difficult not to feel upbeat, as people from coast to coast to coast gather to discuss new findings and new ideas on problems like refractory depression and chronic pain and, yes, schizophrenia. And this is a great time to be involved in mental health care – as stigma fades and societal recognition grows.

But how are we doing in terms of actual outcomes? This week, we look at a new British Journal of Psychiatry paper. Hayes et al. consider mortality for those with severe mental illness and the rest of us. Unfortunately, the authors find that the mortality gap has grown with time.

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Ottawa: Host city of this year’s CPA Annual Conference

In this Reading, we review the paper and an editorial, and consider the larger context.

DG

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Reading of the Week: Doing Things Differently – Clozapine and More

From the Editor

“When a Cape Breton cousin of mine was hospitalized at the main asylum for Nova Scotia in the 1940s with psychotic symptoms, his sister told me the family received a phone call from the treating physician telling them to give up all hope for their brother’s future.”

In his new book written with Dr. Pier Bryden, Dr. David Goldbloom – past Chair of the Mental Health Commission of Canada and Senior Medical Advisor of the Centre for Addiction and Mental Health – recalls the story.

Psychiatry is so much better today.

But there is room for much improvement. Uneven outcomes. Provider-focused care. Can we do things differently?

New approach, better results?

This week, we look at a blog published by HealthAffairs.org, considering the use of clozapine for people with schizophrenia. Dr. Adam Rose, drawing on the research, including his own research, wonders why we don’t use more of this effective treatment.

Then, turning to The Globe and Mail, we look at the life and death of Dr. Kate Granger – a physician who has challenged us health care providers to be more compassionate.

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