Tag: social media

Reading of the Week: Oral Semaglutide for Alcohol Use Disorder – the New AJP Study; Also, Coffee & Cats, and Routledge on Pathologizing Life

August 6, 2026 / David Gratzer / 0 Comments

From the Editor

Only three modestly effective medications have been approved by the U.S. Food and Drug Administration (FDA) for the treatment [of alcohol use disorder]. Novel pharmacological targets are desperately needed.

A new paper begins with an old truth: for some, alcohol misuse is devastating, yet effective medications remain few. What then should we make of oral semaglutide?

In a new study published in The American Journal of Psychiatry – quoted above – Joseph P. Schacht (of the University of Colorado) and his co-authors attempt to answer that question. They report on a phase 2, double-blind, randomized, parallel-arm trial involving 50 participants with alcohol use disorder (AUD) who received oral semaglutide or placebo. “Oral semaglutide significantly reduced alcohol consumption, naturalistic alcohol craving, alcohol-related problems, and cannabis use.” We consider the paper and its implications.

In the second selection, Dr. Jeffrey S. Woods (of the University of Texas at Houston) and his co-authors describe the history of coffee. In a clever paper for Biological Psychiatry, they review the literature, ultimately concluding that coffee may be healthful. “Despite millennia of enmeshment in human culture, over the past 50 years the medical community has treated coffee with caution.”

Finally, in the third selection, Clay Routledge (of the Archbridge Institute) writes about the growing awareness of mental health problems and, ironically, our deteriorating collective mental health. In an essay for The New York Times, he sees a connection. “We should try to spend less time stuck in our heads and more time out in the world, pursuing the kinds of activities that support mental health without making us so obsessed with it.”

Reading of the Week: Controversies & Kids – Papers on Social Media Bans and Smartphone Restrictions; Also, Sexsomnia for Psychiatrists

July 2, 2026 / David Gratzer

From the Editor

Canada’s Parliament is debating a ban. Government officials are discussing similar measures in the UK, Poland, Denmark, and Malaysia. As more and more countries think about restricting kids from access to social media, the Australian experiment is interesting and important. In 2024, Australia passed legislation banning youth under the age of 16 years.

But has the Australian law had an effect on use? In The BMJ, Courtney Barnes (of the University of Newcastle) and her co-authors attempt to answer that question with a prospective observational study. They analyzed survey data collected just before implementation and again three months after it, involving 408 youth. “Despite the intent of the Social Media Minimum Age Act 2024 to delay access to social media platforms and reduce the potential for online harms, little evidence was found of immediate substantive reductions in reported social media use by adolescents under 16 years.” We consider the study and its implications.

In the second selection, Maiara da Silva Martins (of Pontifical Catholic University of Rio Grande do Sul) and her co-authors focus on cellphone restriction in Brazil during the school day. In a letter published in Journal of the American Academy of Child & Adolescent Psychiatry, they report on a longitudinal study involving 1 643 students. “Our findings suggest that school-hour restrictions alone are insufficient to alter the trajectory of internalizing problems like anxiety and withdrawal.”

And in the third selection, from The Canadian Journal of Psychiatry, Dr. Colin M. Shapiro (of the University of Toronto) and his colleagues write about sexsomnia. They note that the condition is more common than previously believed and offer some clinical tips. “For clinicians, the key point is that sexual behaviours during sleep can occur without conscious awareness and should be considered within the broader spectrum of parasomnias during clinical assessment.”

Reading of the Week: Concealing Problems & TikTok – the New JMIR Study; Also, Cannabis in Canada, and Antidepressants & the 2-4 Week Myth

May 28, 2026 / David Gratzer

From the Editor

He spoke about depression and its impact on his life but held back on certain details. Only when his family showed me the texts did I fully understand how ill he really was.

Patients often conceal some aspects of their problems. In a new paper published in the Journal of Medical Internet Research, Chloe Roske (of the Albert Einstein College of Medicine) and her co-authors shed light on this concealment with a creative approach: by analyzing social media. Drawing on nearly 100 TikTok videos with more than 73 million views, they conducted a qualitative analysis. “TikTok creators frequently described concealment as a strategy to avoid perceived punitive consequences, manage interpersonal dynamics, or cope with emotional distress.” We consider the paper and its implications.

In the second selection, Benedikt Fischer (of Simon Fraser University) and his co-authors discuss Canada’s legalization of cannabis, noting a decline in crime but an increase in problematic use. “Nonmedical cannabis legalization in Canada was a milestone policy reform when implemented almost a decade ago. However, complacency about its presently main outcomes would be misplaced, also since its original objectives have been at best partially achieved.”

And, in the third selection, Dr. Stefani Mihilli (of the University of Toronto) and her co-authors discuss antidepressants in a paper for The Canadian Journal of Psychiatry. They focus on the commonly made claim that antidepressants take several weeks to start working. “Telling patients that antidepressants ‘kick in’ after 2–4 weeks is not only potentially inaccurate but also may cause unnecessary distress or even reduce positive outcomes.”

Reading of the Week: Personalized Antidepressant Treatment – the New JAMA Study; Also, Social Media Use & Adolescent Well-Being

March 12, 2026 / David Gratzer

From the Editor

Some patients with depression don’t show improvement. Among the reasons why: they may stop treatment too early. For decades, research on improving outcomes has included biomarkers, trying to better pair illness with treatment. But what about following patient preferences in care decisions? Can this help bolster medication compliance and thus improve outcomes?

In a new, compelling paper that was just published in JAMA, Dr. Andrea Cipriani (of the University of Oxford) and his co-authors attempt to answer these questions. They describe a study involving 540 participants in 47 sites. Participants were randomized to receive either the usual care or care using the PETRUSHKA tool, “a web-based clinical decision-support system combining clinical and demographic predictors with patient preferences to personalize antidepressant treatment.” The results are impressive. “Compared with usual care, participants with MDD whose antidepressant was selected using the PETRUSHKA tool had a reduced risk by approximately 40% of discontinuing their antidepressant during the first 8 weeks of treatment.” We consider the paper and its implications, as well as the accompanying Editorial.

The impact of social media on children and adolescents is much discussed; recently, Australia banned youth who are under 16 years of age from using platforms like Instagram. In this week’s other selection, from JAMA Pediatrics, Ben Singh (of the University of South Australia) and his co-authors analyzed social media’s association with well-being. They describe a cohort study of more than 100 000 Australian adolescents who were followed for three years. They found: “a U-shaped association emerged where moderate social media use was associated with the best well-being outcomes, while both no use and highest use were associated with poorer well-being.”

Note: there will be no Readings for the next two weeks.

Reading of the Week: ECT in Ontario – the New CJP Study; Also, Alcohol & Influencers, and Jayaraman on Chekhov’s Guns

March 5, 2026 / David Gratzer

From the Editor

It’s the most effective treatment for those with treatment-resistant depression. Older studies, including one from Quebec, suggest that it’s much less used than in the past. Is ECT going the way of the dodo bird?

In a new Canadian Journal of Psychiatry study, Dr. Tyler S. Kaster (of the University of Toronto) and his co-authors attempt to answer that question. They drew on 17 years of data, tapping several administrative databases from Ontario, covering more than 450 000 treatments. They offer some good news. “We found that while ECT use generally increased over time, there were notable differences between biological sexes, age groups, and geographic regions.” We consider the paper and its implications.

In the second selection, a research letter published in JAMA Pediatrics, Scott I. Donaldson (of Rutgers University) and his co-authors connect social media content with the desire to drink among young people. Drawing on survey data, they analyzed the impact of lifestyle influencers. “This experimental evidence adds to a growing body of research showing that exposure to alcohol-promoting content, particularly on social media, is associated with alcohol-promoting attitudes and behaviors in young adults.”

Finally, in the third selection, Pranav Jayaraman (of Texas Tech University) writes about diagnoses and patients in Academic Psychiatry. The medical student discusses the temptation to reduce experiences to simple diagnoses. “As I seek to serve patients through psychiatry, a field often facing provider capacity and time constraints, the desire to pinpoint a single cause and address it with a straightforward solution is understandable but can also be limiting.”

Reading of the Week: Less Social Media, Better Mental Health? The New NBER Paper; Also, Harm & School-based Interventions, and Jones on Her Psychosis

September 25, 2025 / David Gratzer

From the Editor

11.

This month, Reading of the Week celebrates its 11^th birthday. Thanks for continuing to read.

Does quitting social media enhance emotional wellbeing? In the first selection, Hunt Allcott (of Stanford University) and his co-authors attempt to answer this question in a paper for NBER. In a randomized trial, they assigned more than 35 000 social media users to either a social media-free group or one where people continued to use Facebook and Instagram. “Our estimates suggest that deactivating Facebook or Instagram before the 2020 election improved people’s emotional state…” We consider the paper and its implications.

In the second selection, Carolina Guzman Holst (of Oxford University) and her co-authors look at school-based mental health interventions and potential harms in a new Child and Adolescent Mental Health paper. In their scoping review, they drew on 120 studies involving CBT and mindfulness. “Overall, our study suggests that a minority (8.93%) of these interventions finds at least one negative outcome and that, to date, no adverse events linked to the intervention itself have been reported.”

And in the third selection, Alexandra Jones writes about her postpartum psychosis in a paper for The Lancet Psychiatry. After a quick labour and delivery, she notes changes with her mental health. She tries to seek care – but only becomes more ill. Eventually, she is hospitalized. “Postpartum psychosis is a psychiatric emergency, and women with postpartum psychosis deserve greater compassion and support underpinned by increased education, research and resources.”

Reading of the Week: ADHD – with Papers from JAMA Psych, PLOS One & Psych Services

April 3, 2025 / David Gratzer

From the Editor

He had struggled for years with mood and ADHD. While we discussed different medication options, my patient was very focused on psychedelics; he explained that his friends had found microdosing to be helpful, especially for their attentional problems.

Psychedelics have entered the mainstream: research is active; patients seem increasingly interested; and, yes, investors offer up billions in the rush to find potential treatments (and profit). But is there evidence for psychedelics for those with ADHD? Dr. Lorenz Mueller (of the University of Basel) and his colleagues attempt to answer that question with a new paper, just published in JAMA Psychiatry. They describe the first double-blind, placebo-controlled phase 2A randomized clinical trial. 52 participants received repeated doses of LSD (twice weekly) or placebo over six weeks. “In this randomized clinical trial, repeated low-dose LSD administration was safe in an outpatient setting, but it was not more efficacious than placebo in reducing ADHD symptoms.” We consider the paper and its implications.

The molecular structure of LSD – pretty but useful for ADHD?

In the second selection, Vasileia Karasavva (of the University of British Columbia) and her co-authors look at ADHD and social media in a new paper for PLOS One. In a two-part study, they analyzed 100 popular videos on ADHD, finding many views but uneven quality. While they note the “democratizing” of mental health information, they warn: “TikTok’s anecdotal content could lead some viewers to misattribute normal behaviors or those better explained by other conditions to be signs of ADHD…”

In the third selection, Dr. Zilin Cui (of Boston University) writes about ADHD – as a provider and also as a patient. In a personal Psychiatric Services paper, the physician discloses long-standing problems and a diagnosis. She also writes about cultural considerations. “Instead of continuing to dwell on what I cannot do, I now have different tools and strategies to chart my path forward. Now, I can finally tell myself that I am enough.”

Reading of the Week: Social Media – with Papers from Digital Health & BJP, and Dr. Vivek Murthy on Warning Labels

February 6, 2025 / David Gratzer

From the Editor

“I know all about antidepressants,” the young patient told me in the ED. “I’ve seen TikTok videos.” Social media isn’t just a source of great cat videos, many individuals – especially younger patients – turn to it for health information.

But how reliable is the mental-health information? In a new Digital Health paper, Roxanne Turuba (of the University of British Columbia) and her co-authors report on a summative content analysis of the 1 000 most popular mental health TikTok videos. They found that many featured personal stories and confessionals; less than 4% referenced scientific evidence; about a third offering advice was misleading. “Healthcare practitioners and researchers may consider increasing their presence on the platform to promote the dissemination of evidence-based information to a wider and more youth-targeted population.” We examine the paper and its implications.

Social media: more than cat videos?

In the second selection, Harriet Battle (of the South London and Maudsley NHS Foundation Trust) and her co-authors consider attitudes toward mental health providers in social media. In a new British Journal of Psychiatry study, they analyzed more than 300 000 tweets spanning over a 16-year period, finding: “positive perceptions of mental health and mental health professionals increased over time. However, ‘psychiatrist’ had a consistently higher proportion of negative perceptions.”

And in the third selection, Dr. Vivek H. Murthy (the former US Surgeon General) writes about social media and adolescents in a New York Times essay. He notes the potential harms of social media for youth. He advocates changes, including warning labels. “We have the expertise, resources and tools to make social media safe for our kids. Now is the time to summon the will to act.”

Reading of the Week: Written Exposure Therapy for PTSD – the New JAMA Psychiatry Paper; Also, #MedEd & Knowledge Translation

September 14, 2023 / David Gratzer

From the Editor

How to help those with PTSD? Prolonged exposure therapy (PE) and cognitive processing therapy (CPT) are supported by good evidence but both are resource intense and often have high drop-out rates, partly because of the requirement that patients complete homework. Is there an alternative?

In the first selection, we look at a new study considering written exposure therapy (WET), an emerging therapy where patients write about traumatic events – but the therapy doesn’t demand so much from the system (in terms of resources) or patients (in terms of homework assignments). Denise Sloan (of Boston University) and her colleagues conducted a noninferiority trial, comparing this therapy with prolonged exposure therapy for US veterans with PTSD, involving 178 participants from three centres. “We found WET was noninferior to PE, a treatment that includes more treatment sessions, longer sessions, and between-session assignments.” We consider the study, an Editorial responding to it, and mull the clinical implications.

In the last selection, John W. Ayers (of the University of California San Diego, La Jolla) and his co-authors consider social media and medical education in JAMA. They argue that #MedEd is a dynamic platform with the potential to democratize medical education – but also warn of the problems of misinformation. “The potential for #MedEd to improve medical education and the health sciences is considerable, while the risks of dismissing #MedEd is potentially greater.”