Tag: Sinyor

Reading of the Week: Cuijpers on Depression Treatment (WP); Also, Suicide (NEJM), and Sinyor on DeRozan & Depression (Star)

From the Editor

How to treat depression? How do we approach suicide? Who is the greatest Raptor of all time?

This week, we consider three pieces.

In the first selection, Pim Cuijpers (Vrije Universiteit Amsterdam) and his co-authors do a network meta-analysis of depression treatment, weighing psychotherapy, pharmacotherapy, and the combination of the two. They find: “combined treatment is more effective than psychotherapy or pharmacotherapy alone in the short‐term treatment of moderate depression, and there are no significant differences between psychotherapy and pharmacotherapy.”

In a short New England Journal of Medicine paper, Drs. Seena Fazel (Oxford University) and Bo Runeson (Karolinska Institutet) review a topic of relevance to all clinicians: suicide. “Management of suicidality calls for a comprehensive approach to assessment and treatment.”

TORONTO, ON - SEPTEMBER, 25 DeMar DeRozen poses for photos. It was media day for the Toronto Raptors at their training facility, the BioSteel Centre. Coaches and players met with media, answered questions and had a variety of photographs taken. (Richard Lautens/Toronto Star via Getty Images)Yes, we talk about basketball this week

Finally, in the third selection, the University of Toronto’s Dr. Mark Sinyor writes about basketball and his favourite Raptor – and, yes, stigma.

DG

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Reading of the Week: Mental Health & the Opinion Pages – Mental Health Reform (Star), ECT (Guardian), and Suicide and “13 Reasons Why” (LA Times)

From the Editor

“Mental health is out of the closet. Now that we’ve opened the door, time for a closer look at what’s been out of sight for so long.”

This week, we consider three selections. They appeared in newspapers in recent days, and discuss mental health topics. The opening quotation – which is from the first essay – applies to all of them; a closer look: calls for more debate about how mental health services are organized, the care that patients are offered, and the way mental illness is portrayed in our culture.

In our first selection, we consider an op ed from Toronto Star columnist Martin Regg Cohn. He wonders about improving access to mental health care. In a provocative essay, he mulls the mismatch between the supply and demand of services (particularly psychiatric services). He argues: “We might as well accept that our mental health spending will increase significantly over the years. All the more reason to start reallocating funds wisely now.”

newspapersThree Selections, Three Newspapers

In the second selection, we look at an essay by Dr. Mariam Alexander, an NHS psychiatrist, who discusses ECT. She opens simply: “It might come as quite a surprise to learn that, as a psychiatrist, if I ever had the misfortune to develop severe depression, my treatment of choice would be electroconvulsive therapy (ECT).”

And in our third selection, the University of Toronto’s Dr. Mark Sinyor considers the popular show “13 Reasons Why” and offers a cautionary note about the portrayal of suicide. The LA Times op ed notes that Netflix and others have “the potential to do good in the world when handling sensitive mental health issues.”

Enjoy.

DG

 

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Reading of the Week: Vulnerable Youth & ‘13 Reasons Why’ — the New Psych Services Paper; Also, Dr. Orford Considers his Brother’s Suicide in JAMA

From the Editor

It’s a hit show. Is it dangerous?

Since its launch, 13 Reasons Why has been highly controversial; the storyline of the Netflix series revolves around a teenager’s decision to suicide – which is graphically depicted over three minutes in one episode.

In this week’s Reading, we look at a new Psychiatric Services paper. University of Michigan’s Dr. Victor Hong and his co-authors consider the impact of the show on youth seeking psychiatric care for suicide-related risk. While other studies have analyzed the response in the larger community (including google searches), this study focuses on a vulnerable population. They find: “For certain youths, watching the series correlated with a perceived nonzero elevation in their suicide risk; identification with the main female character and strong affective reactions may be markers of increased risk associated with viewing the show.”

13-reasons-picBig buzz, big problem?

In the other selection, we look at a short essay recently published in JAMA. In “Grief After Suicide,” Dr. Orford discusses the suicide of his brother. The Deakin University intensivist notes that: “As a physician, I have cared for thousands of patients and families in the last hours and days of life. I have listened, watched, and learned.” The loss of his brother, however, continues to have a major effect on his life, three decades later.

DG

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Reading of the Week: Suicidal? Get a Postcard. The New JCP Paper on Suicide Prevention. Also, Ketamine & Inpatients

From the Editor

Can we do better at suicide prevention?

In recent years, several studies have tried brief contact interventions – that is, interventions aimed at maintaining a post-discharge connection – reporting success. These interventions have been relatively simple, such as handwritten postcards or phone calls for people post-attempt.

In this week’s selection, we look at a new paper from The Journal of Clinical Psychiatry. Involving 23 emergency departments and crisis centres in France, the authors pulled together different interventions, coming up with an algorithm offering patients care informed by the best evidence. So some patients received calls, but others were given crisis cards.

It’s an ambitious project. Did it work? The results weren’t statistically significant.

p1110389Postcards: colourful and pretty – and life-saving?

We consider this paper, the negative result, and ask: what does this say about suicide prevention? And then, looking at the evolving literature on suicide, we briefly consider a paper written by Sunnybook’s Mark Sinyor that uses IV ketamine for suicidal thoughts.

Please note: there will be no Reading next week.

DG
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Reading of the Week: Suicide & the News – the New CPA Media Guidelines for Reporting on Suicide

From the Editor

“Hemingway Dead of Shotgun Wound; Wife Says He Was Cleaning Weapon.” So reads the headline from the front page of The New York Times reporting the death of author Ernest Hemingway. It quotes Frank Hewitt, the Blaine County Sheriff, who comments that the death “looks like an accident… There is no evidence of foul play.”

It is well known that writer Ernest Hemingway died by suicide – the sheriff didn’t want to say it. As we as a society discuss mental illness more and more, how do we discuss topics like suicide? For years, of course, we didn’t – or, if we did, reporting was often insensitive.

In last month’s Canadian Journal of Psychiatry, Sunnybrook Hospital’s Mark Sinyor and his co-authors, including other psychiatrists and journalists, suggest guidelines for the reporting of suicide. The effort provides an update of a past report, and includes recommendations for social media.

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In this Reading we look at the guidelines, and consider the opportunities and problems of the Twitter era.

DG

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Reading of the Week: Do Suicide Barriers Work? Sinyor et al. on the Bloor Viaduct and Toronto Suicides

From the Editor

Do suicide barriers really work, or do they cost money that could have been better spent elsewhere?

This debate raged in Toronto about a decade and a half ago when some argued that a suicide barrier must be added to the Bloor Viaduct. That bridge, which connects downtown Toronto with its east end, was considered a “suicide magnet” – a place that proved popular for suicide attempts. In North America, only the Golden Gate Bridge in San Francisco had more suicides associated with it. Media coverage of the debate included an article in The New York Times; it ran with the dramatic headline: “A Veil of Deterrence for a Bridge With a Dark Side.”

And in 2003, the barrier went up.

So did the suicide rate go down?

This week, we look at a new paper just published by Sunnybrook’s Mark Sinyor et al. Drawing on years of data, they consider the utility of the Bloor Viaduct suicide barrier. They find that it has saved lives. The paper obviously has implications for other bridges and cities.

The Bloor Viaduct: big debate, big outcome?

The authors also looked at media reporting on suicide.

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Reading of the Week: Physician, Heal Thyself: Residents and Depression, and More

From the Editor

This week – like last week – we pick a few interesting readings to consider.

This week’s selections: a chef and his addiction, a major new JAMA paper on resident physicians and depressive symptoms, and a big paper from BMJ comparing CBT and meds for depression.

Next week: the best of the year (the annual tradition). Suggestions are welcome for the best papers of 2015.

DG

Selection 1

“Three years after his mysterious disappearance, former Langdon Hall chef breaks his silence”

Mark Schatzker, The Globe and Mail, 1 December 2015

On the night of Dec. 28, 2012, Jonathan Gushue, one of Canada’s most decorated chefs, disappeared. He finished a dinner service at Langdon Hall that included pickerel in crème fraîche with black radish and black-pepper honey, got into his car and never arrived home.

No one, including Gushue’s wife, his sous chefs and his friends, knew what had happened to the 41-year-old father of three who, just two years earlier, had put Langdon Hall, in Cambridge, Ont., on the prestigious San Pellegrino World’s Best Restaurants list. As the chef’s disappearance made headlines from coast to coast, mysterious details began leaking out – his phone was found at an upscale Toronto hotel – but nothing more.

Thirteen days later, Gushue was found and reported safe. Several months later, he left Langdon Hall, then vanished from public life.

Jonathan Gushue

Gushue had it all – a young family and a soaring career. He also had alcoholism. Continue reading