Tag: Schizophrenia

Reading of the Week: Help-seeking & Gambling – the New CMAJ Study; Also, Women With Schizophrenia, and Dr. Campo on Patients & Faith

June 18, 2026 / / 0 Comments

From the Editor

Can Argentina repeat? Could England end its six-decade drought? Roughly five billion people will watch this year’s World Cup. The tournament can be understood in different ways: a great sporting event, a giant party, and, yes, a huge draw for gamblers. In Ontario – and across North America – recent laws have dramatically expanded gambling options. How have such changes affected problem gambling and the need for help? 

In a new CMAJ study, Ryan Forrest (of the University of Toronto) and his co-authors attempt to answer that question. They drew on Ontario data to quantify the increase in help-seeking following the launch of a government-operated online gambling platform in January 2015 and the subsequent expansion of private online gambling. They analyzed almost 750 000 contacts to a helpline over 13 years, finding that the mean monthly rate of gambling-related contacts nearly doubled. “The rapid expansion and privatization of online gambling, including single-event sports betting, in Ontario were respectively associated with marked increases in gambling-related helpline contacts, specifically among adolescent boys and young men.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Laura M. Rowland (of the University of Maryland) and Dr. Ellen E. Lee (of the University of California San Diego) write about schizophrenia and women. “The lack of focused health research on women in general is well recognized, and mental health research remains no exception. Surprisingly, there is also a lack of mental health research on older people with schizophrenia with less than 5% of scientific publications on schizophrenia dedicated to this older group.”

Finally, in the third selection, Dr. John V. Campo (of Johns Hopkins University) discusses faith and psychiatry. In a personal essay for The Washington Post, he notes his own religious experience and declining health. “Taking our patients seriously requires physicians to explore issues of ultimate concern, suggesting that a spiritual history should be an expected component of any comprehensive clinical evaluation.”

DG

Continue reading

Reading of the Week: Trauma & Schizophrenia – the New AJP Study; Also, AI Chatbot & US Teens, and Gunther on the Blessings & Curses of Meds

June 11, 2026 / / 0 Comments

From the Editor

Can a parent’s trauma influence the development of mental illness in his or her child? Research suggests an intergenerational link for several disorders, including PTSD. But what about schizophrenia? Complicating such research: the complexity of genetics, environment, and trauma – and the limits of data.

In a new American Journal of Psychiatry paper, published last week, Iaroslav Youssim (of the Hebrew University of Jerusalem) and his co-authors attempt to answer these questions by looking at parental exposure to the Holocaust – years before conception – and the associated risk of schizophrenia in their children. They drew data from 92 000 births in West Jerusalem between 1964 and 1976. “Offspring of mothers who were older than age 5 when Nazi persecutions began showed over a twofold increase in schizophrenia risk, underscoring the potential impact of trauma and its timing during the preconception period in the pathogenesis of schizophrenia.” We consider the study and its implications.

How often do adolescents and young adults use AI chatbots for mental health? In the second selection, from JAMA Pediatrics, Ryan K. McBain (of RAND) and his co-authors report on a US survey. They find that one in five youth use AI chatbots for mental health advice. “AI chatbots are already embedded in many youths’ mental health information ecosystem, underscoring the need for parents and clinicians to proactively discuss chatbot use to promote safety, appropriate expectations, and linkages to evidence-based care.”

And in the third selection, Sarah M. Gunther discusses medications and her journey in Psychiatric Services. In her personal essay, she describes trying different meds over time and the problems that they caused. She finally lands on the right combination. “I tell this story so that others won’t give up, and so doctors can see that the medications that they prescribe can make an illness worse.”

DG

Continue reading

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

Continue reading

Reading of the Week: Are the Kids Alright? The New JAMA Paper on Mental Disorders & Children; Also, the Remarkable Life of Dr. Mary Seeman

May 1, 2025 /

From the Editor

Are children experiencing more mental disorders than before, or are we simply getting better at screening for them? Many have opinions and there is debate among psychiatrists and within our society.

In a new JAMA paper, Janet R. Cummings (of Emory University) and her co-authors provide new data shedding light on this issue. Drawing on US government databases covering 22 states and from 2010 to 2019, they looked at diagnoses and demographics among economically disadvantaged children. “This observational study found that the percentage of publicly insured children diagnosed with any mental health or neurodevelopmental disorder increased from 10.7% in 2010 to 16.5% in 2019.” We consider the paper and the accompanying Editorial – and wonder if this reflects better screening or more illness. 

In this week’s other selection, we look at the life and career of Dr. Mary Seeman, who died in 2024. In an obituary for The Canadian Journal of Psychiatry, Dr. Robert B. Zipursky (of the University of Toronto) and his co-authors note her many contributions to psychiatry. “Although Mary was 89 years old at the time of her death, her passion, humour, curiosity, and productivity had not abated. It endures now in the legacy of her scientific work, in her teaching and clinical care and in the many people she inspired to follow her example.”

DG


Continue reading

Reading of the Week: AI Chatbots for Mental Healthcare – the New NEJM AI Paper; Also, Neuromodulation for Schizophrenia (AJP)

April 10, 2025 /

From the Editor

Thought logs. Homework. Exposure. Psychotherapy is evidenced for the treatment of many mental disorders – but access is problematic. Can technology help? Is AI a game changer?

In a new NEJM AI paper, Dr. Michael V. Heinz (of Dartmouth College) and his co-authors attempt to answer these questions. In an RCT, they compared 210 participants receiving a chatbot intervention (Therabot) with a control group, analyzing symptoms of mood, anxiety, and disordered eating. “As the first RCT of its kind, our study supports the feasibility, acceptability, and effectiveness of a fine-tuned, fully GenAI–powered chatbot for treating mental health symptoms.” We consider the paper and its implications, and tap the expertise of Dr. John Torous (of Harvard University).

An AI bot for better mental health?

In this week’s other selection, we look at a new review from The American Journal of Psychiatry. Drs. Nicholas H. Neufeld and Daniel M. Blumberger (both of the University of Toronto) provide an update on neuromodulation strategies for schizophrenia, drawing on nearly 140 citations and reviewing different technologies “that span electrical, magnetic, and ultrasound forms of stimulation.” They note: “The evolution of interventions holds the promise of fewer adverse effects and a noninvasive approach, increasing the scale at which these interventions may be offered in hospital and community settings.”

DG

Continue reading

Reading of the Week: ED Visits, Hallucinogens & the Risk of Schizophrenia – the New JAMA Psych Study; Also, Alcohol After COVID and Diab on Being Open

November 21, 2024 /

From the Editor

For my patient who had tried several antidepressants, psilocybin offered hope. He’s not alone; hallucinogens are gaining attention, with many using them for purposes ranging from treating mental disorders to recreation. But how safe are these drugs, especially as their use increasingly occurs outside of clinical settings? What’s the connection with psychosis?

In the first selection, Dr. Daniel T. Myran (of the University of Ottawa) and his co-authors attempt to answer these questions in a new study published in JAMA Psychiatry. The population-based study included over nine million people who had visited an ED in Ontario, Canada over a 13-year period. The researchers compared individuals with an ED visit involving hallucinogen use to the general population and to those with ED visits involving other substances, analyzing the risk of developing a psychotic disorder. “Individuals with an ED visit involving hallucinogen use had a 21-fold greater risk of developing a schizophrenia spectrum disorder compared with the general population…” We consider the study and its implications.

Substance use rose during the early days of the pandemic. Did this trend change after lockdowns and social isolation ended? Dr. Divya Ayyala-Somayajula (of Thomas Jefferson University) and her co-authors analyzed US data related to alcohol use in a research letter for Annals of Internal Medicine. They compared the prevalence of alcohol use and heavy alcohol use before the pandemic, during the pandemic, and in 2020, finding “absolute increases of 2.7% (relative increase, 4.0%) and 1.0% (relative increase, 20.2%) and that the increases were sustained in 2022.”

And in the third selection, writer Saddal Diab discusses her decision to publicly acknowledge her mental disorder. Though people were initially supportive, things changed when she has a manic episode. She considers stigma and acceptance in this Globe and Mail essay. “Whatever gushy feelings had surfaced when I came out did not withstand the reality of mania. This left me feeling ashamed, deserted and questioning the nature of my relationships (which I concluded were flimsier than I had anticipated).”

DG

Continue reading

Reading of the Week: Psychological Interventions for Schizophrenia – the New Lancet Psych Study; Also, Service Dogs for PTSD, and the Latest in the News

July 4, 2024 /

From the Editor

She was distressed by the voices and the paranoid thoughts. Many nights, my patient could barely sleep. She had tried several medications without much improvement. Is there a role for psychological interventions? Would CBT help? What is the evidence for this population?

In the first selection, Nurul Husna Salahuddin (of the Technical University of Munich) and co-authors attempt to answer these questions in a new systematic review and network meta-analysis, just published in Lancet Psychiatry. The analyzed 52 RCTs with 5 034 participants. “We provide robust findings that CBTp can reduce the overall symptoms of patients with treatment-resistant schizophrenia, and therefore clinicians can prioritise this intervention in their clinical practice.” We consider the paper and its clinical implications.

In the second selection from JAMA Network Open, Sarah C. Leighton (of the University of Arizona) and her co-authors describe a study involving service dogs for those with PTSD. In a nonrandomized controlled trial involving 156 military members and veterans, they examined outcomes after three months. “[C]ompared with usual care alone, partnership with a trained psychiatric service dog was associated with lower PTSD symptom severity and higher psychosocial functioning in veterans.”

Finally, we explore the latest news with recent articles from The Guardian, the Ottawa Citizen, and The New York Times. Among the topics: “honest” obituaries and the opioid crisis, antidepressants and withdrawal, and care for pregnant women with substance problems.

DG

Continue reading

Reading of the Week: Visual Hallucinations & Outcomes – the New Schizophrenia Study; Also, Opioid Deaths in Canada and Dr. Roy Perlis on Antidepressants

April 25, 2024 /

From the Editor

Last week, I met a person who had deeply unsettling auditory hallucinations. I asked him the questions that we all ask: When did the voices start? How many voices do you hear? Do the voices tell you to do things? In contrast, while we know that people with psychotic illnesses can have visual hallucinations, we rarely inquire about them and if we do, it’s in a perfunctory manner, as I did with him. Clinicians aren’t the only ones to gloss over visual hallucinations; they tend to be under-researched, especially with regard to long-term outcomes.

In the first selection, Isabel Kreis (of the University of Oslo) and her co-authors look at outcomes and visual hallucinations in an impressive, new study published in Schizophrenia. They report on 184 people from Norway with first-episode psychosis, followed for ten years, with a focus on visual hallucinations and functionality, suicide attempts, and childhood trauma. “These findings highlight the relevance of assessing visual hallucinations and monitoring their development over time.” We consider the paper and its implications.

In the second selection from CMAJ, Shaleesa Ledlie (of the University of Toronto) and her co-authors report on opioid-related deaths in Canada. They drew from a national database and looked at several years of data, including over the start of the pandemic. “Across Canada, the burden of premature opioid-related deaths doubled between 2019 and 2021, representing more than one-quarter of deaths among younger adults.”

And in the third selection, Dr. Roy Perlis (of Harvard University) argues that the time has come for over-the-counter antidepressants in a STAT essay. He notes that many people with depression are untreated and that increasing the availability of these medications would be helpful. “With part of the solution hiding in plain sight, it’s time to do everything possible to give Americans another way to get treatment.”

DG

Continue reading

Reading of the Week: Global Burden of Schizophrenia – the new Molecular Psych Study; Also, MedEd’s Evolution & Saxbe on Helping Depressed Teens

November 30, 2023 /

From the Editor

Is there more mental illness than before? Or is there greater awareness? 

Dr. Marco Solmi (of the University of Ottawa) and his co-authors attempt to answer these questions in a new paper for Molecular Psychiatry that focuses on schizophrenia. Drawing on 30 years of data globally, they consider prevalence (how many have the illness), incidence (the number who develop it each year), and the disability-adjusted life-years (the loss of one healthy year of life) using more than 86 000 points of data. They find: “Globally, we show that, from 1990 to 2019, raw prevalence increased by over 65%, incidence by 37.11%, DALYs by over 65%, but age-adjusted prevalence and incidence estimates showed a slight decrease, and burden did not change.” We consider the paper and its implications.

Textbooks, highlighters, and classrooms? The world of medical education is changing. Today, we have AI, sim, and e-learning. In the second selection, we look at the new Quick Takes podcast with Dr. Ivan Silver (of the University of Toronto), former vice president of education at CAMH who marvels at the potential. “This is the renaissance period for health professional education.” 

And in the third selection, psychologist Darby Saxbe (of the University of Southern California) writes in The New York Times about ways to help depressed adolescents. Drawing on recent studies showing the failure of school-based psychosocial interventions, she argues for a different approach. “It’s critical to keep pace with the evidence and attend to the first principle of all health care providers: First, do no harm.”

DG

Continue reading

Reading of the Week: Running vs SSRIs for Depression – the new JAD Paper; Also, Climate Change & Mental Health, and Understanding My Schizophrenia

October 26, 2023 /

From the Editor

“Go for a Run to Beat Depression – It’s Just As Effective As Taking Medication”

– New York Post

“Running could be just as effective at treating depression as medication, scientists find”

– The Independent

Patients often ask what they can do to get better from their depression. Should we be advising them to put on a pair of runners and go for a jog? A new paper published in the Journal of Affective Disorders seems to suggest as much – and it’s caused a bit of media buzz. In the first selection, Josine E. Verhoeven (of Vrije Universiteit Amsterdam) and her co-authors describe this 16-week study that offered 141 people with depression and/or anxiety either a running intervention or medications, and looked at several mental and physical health outcomes. “We showed that while antidepressant medication and running therapy did not statistically significantly differ on mental health outcomes… the interventions had a significantly different and often contrasting impact on several physical health outcomes, with more favorable outcomes for those in the exercise intervention.” We consider the paper and its implications.

In the second selection, Pim Cuijpers (of Vrije Universiteit Amsterdam) and his co-authors discuss climate change and mental health in a new viewpoint for JAMA Psychiatry. Though they note the lack of high-quality research in the area, they argue that it would disproportionately affect low and middle-income nations. They then point a way forward. “There is no doubt that climate change will have a major impact on mental health in the coming decades.”

And in the third selection which is written anonymously, a person with schizophrenia talks about his experiences in a paper for Schizophrenia Bulletin. He tries to empower himself, working to limit side effects and cope with the voices. “My brain disease is incurable, but it is not an excuse for me to be irresponsible or to give up on life.” 

DG

Continue reading