Tag: treatment

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

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

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Reading of the Week: Drugs, Drugs, Drugs – Vermont Tries To Break The Addiction Cycle, and Minister Philpott Weighs In On Opioids

From the Editor

“I don’t think that we can sit back and be complacent for one moment,” said Toronto Mayor John Tory in a media interview in which he called for an ‘all hands on deck’ approach to dealing with opioids.

It’s a comment on our times when the mayor of Canada’s largest city is focused on the use (and abuse) of opioids. And so are others – opioid addiction has sparked conversations across North America, from big city Canada to rural America. In 2014, Peter Shumlin, governor of the second smallest state in the U.S., devoted his annual address to the opioid problem striking “every corner” of Vermont.

Vermont: hills, lakes, opioids

How we deal with opioids is complicated, touching on everything from drug regulation to clinician education. But the legal response is particularly interesting – the intersection of the law, addiction, and public policy. And so, in this Reading, we look at the Green Mountain State. In a Wall Street Journal essay, reporters Jennifer Levitz and Scott Calvert discuss Vermont’s experimentation with mandatory treatment for minor drug-related crimes – and the struggles of a young user.

We also consider federal Minister of Health Jane Philpott’s recent essay on the opioid issue, which ran in The Globe and Mail last week. She calls on us to address the roots of the issue – which “are tangled and deep.”

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