Tag: Shen

Reading of the Week: Novel Depression Care – the New JAMA Psychiatry Study; Also, Psych Beds in the US and ChatGPT & Sensitive Conversations

November 6, 2025 /

From the Editor

He had several antidepressant trials. rTMS was helpful but the improvement faded quickly. Should he try ketamine? My patient had read good things and asked.

In a new paper for JAMA Psychiatry, Ana Jelovac (of Trinity College Dublin) and her co-authors attempt to answer that question. 62 hospitalized patients with depression were randomly assigned to receive either repeated ketamine or midazolam treatment and were followed for 24 weeks afterwards. “Serial adjunctive ketamine infusions were not more effective than serial midazolam infusions in reducing depressive symptoms in inpatients receiving usual psychiatric care.” We consider the paper and its implications.

How has the supply of US psychiatric beds changed with time? In the second selection, from JAMA Psychiatry, Karen Shen (of Johns Hopkins University) and her co-authors drew on US databases, finding a slight reduction in overall beds but perhaps an increase in acute care supply, albeit with an increase in beds from large for-profit hospital chains. “Given reports of safety concerns at large for-profit chains, our findings also underscore the need for research on the effects of growing corporatization of inpatient mental health care on patient outcomes.”

And in the third selection, published on their website, ChatGPT staff write about recent controversies involving those with mental health problems, suggesting that the organization has been moved to action. The essay describes their efforts to make advice safer and more appropriate for users who are psychotic, suicidal, or becoming emotionally reliant on AI. “We worked with more than 170 mental health experts to help ChatGPT more reliably recognize signs of distress, respond with care, and guide people toward real-world support – reducing responses that fall short of our desired behavior by 65-80%.”

DG

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Reading of the Week: Depression: Is There an App for That?

July 9, 2015 /

Depression is a serious, common, and recurring disorder linked to diminished functioning, quality of life, medical morbidity, and mortality. There has been a 37.5% increase in health life years lost to depression over the past two decades. Depression was the third-leading cause of global burden of disease in 2004 and the leading cause of burden of disease in high- and middle-income countries. It is projected to be the leading cause globally in 2030. While effective treatments for depression are available, they are underused. Barriers to treatment include geography, socioeconomic status, system capacity, treatment costs (direct and indirect), low mental health literacy, cultural beliefs, and stigma. A 2010 study found that 75% of primary care patients with depression in urban areas could identify more than one structural, psychological, cultural, or emotional barrier to accessing behavioral treatments. The rate was substantially higher in rural areas.

So begins a new paper that considers an old problem – the difficulty of patients accessing mental health care.

But this paper is different. It considers a modern approach to access: smartphone and tablet applications (or apps) for depression. And it’s not just the topic that is so modern with this week’s Reading. Consider: the paper was published in a new journal, JMIR mHealth and uHealth, available only on-line, and focused on the very modern topic of mobile health. (This journal is a spin-off of JMIR, the Journal of Medical Internet Research, itself a relatively new journal, which boasts an impact factor of 4.7 in 2013.)

This week’s Reading: “Finding a Depression App: A Review and Content Analysis of the Depression App Marketplace” by Nelson Shen et al. In it, the authors seek to shed light on a poorly studied area. As they note early in the paper, despite the incredible popularity of apps, only one recent systemic review looked at depression apps, and included just 4 papers. And so, Shen et al. consider apps for depression, drawing out common characteristics and purposes.

This is, then, an important topic. The potential here is great: with so many of our patients empowering themselves with apps, those with depression could potentially access good information, screening tools and even treatments such as CBT.

What did Shen et al. find in their paper? It’s best summarized by the old Roman phrase caveat emptor (let the buyer beware). Continue reading