TagThe Journal of Clinical Psychiatry

Reading of the Week: Measurement-based Care – What’s the Evidence? Also, Goldbloom on the Joy of Jabbing

From the Editor

Well, he looks better.

So often our conversations about patients – in our emergency rooms, wards, and clinics – focus on soft evidence of improvement. No wonder: psychiatry lacks biomarkers. And so, while our colleagues in medicine talk about blood sugars and white blood cell counts, we often discuss other things, like how our patients look and sound.

The promise of measurement-based care: objective evidence of change (or lack thereof). The idea is having a moment, with more and more interest. But what does the literature say?

In the first selection, Maria Zhu (of the University of British Columbia) and her colleagues consider RCTs. In a systematic review and meta-analysis, they look at the efficacy of measurement-based care for depressive disorders. They conclude: “Although benefits for clinical response are unclear, MBC is effective in decreasing depression severity, promoting remission, and improving medication adherence in patients with depressive disorders treated with pharmacotherapy. The results are limited by the small number of included trials, high risk of bias, and significant study heterogeneity.” We discuss the big paper.

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The pandemic has changed much with day-to-day practice, including with the rapid virtualization of mental health care. Remember a time when you didn’t need to talk about “being on mute?” And some psychiatrists have been on the front lines of the vaccine effort. In the second selection, Dr. David Goldbloom (of the University of Toronto) writes about his experiences working in a vaccine clinic. His Toronto Lifeessay details the YouTube video he watched to remind himself of how to administer shots, his family ties to vaccinations, and his fondness for the work. “I will always be grateful to have experienced the joy of jabbing.”

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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