Twittering on about mental health: is it worth the effort?
The medical community disseminates information increasingly using social media. Randomised controlled trials are being conducted in this area to evaluate effectiveness of social media with mixed results so far, but more trials are likely to be published in the coming years. One recent twitter randomised control trial using Cochrane Schizophrenia Group reviews suggests that tweets increase the hits to the target web page by about threefold and time spent on the web page is also increased threefold when referrals come in via twitter. These are early findings and need further replication. Twitter appeals to professionals, ent...
Source: Evidence-Based Mental Health - January 19, 2017 Category: Psychiatry & Psychology Authors: Jayaram, M., Moran, L., Adams, C. Tags: Perspective Source Type: research
Are molecular scanners going to make double-blind placebo-controlled trials impossible?
Dear Editor, It almost looks like science fiction, but recently a molecular scanner (called SCiOS), which costs less than US$150, has hit the market (http://www.consumerphysics.com/myscio/scio/). It is advertised as being able to provide information on materials, including the composition and calories of food, quality of fruits and even details concerning the manufacture of perfumes. Future uses will probably include the development of a type of medical sensor to analyse biological material. It is reported to work by using near-infrared spectroscopy. There is one aspect of this new technology and the resulting gadget which...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Fountoulakis, K. N. Tags: Letter Source Type: research
Second-generation antidepressants and cognitive-behavioural therapy are both viable choices for initial treatment of major depression
ABSTRACT FROM: Amick HR, Gartlehner G, Gaynes BN, et al. Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. BMJ 2015;351:h6019. What is already known on this topic There is a pressing need to generate clear hierarchies of the benefits and harms of available treatments to implement optimal clinical practice. Second-generation antidepressants (SGAs) and cognitive–behavioural therapy (CBT) have proven efficacy in the treatment of major depression.1 However, comparative benefits and ...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Nakagawa, A. Tags: Miscellaneous Source Type: research
Does community-based suicide prevention decrease suicide attempts? Strategies for reaching zero suicide
This study advances work on suicide prevention and intervention implementation/dissemination research. Rigorous suicide prevention research is critically needed, as suicide is the second leading cause of death among adolescents and young adults in the USA.1 The Garrett Lee Smith (GLS) Memorial Youth Suicide Prevention Programme is a US federal initiative that by June 2014 funded multiple community-based suicide prevention programmes across the USA (49 states, 48 tribes).2 This study examines the impact of the GLS programme on non-fatal suicide attempts (SAs), by comparing SA rates over time in counties that implemented GLS...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Asarnow, J. R., Wang, P. Tags: Miscellaneous Source Type: research
No evidence that CBT is less effective than antidepressants in moderate to severe depression
ABSTRACT FROM: Weitz ES, Hollon SD, Twisk J, et al. Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy: an individual patient data meta-analysis. JAMA Psychiatry 2015;72:1102–9. What is already known on this topic Some guidelines for the treatment of severe depression recommend that antidepressant medication be used instead of cognitive–behavioural therapy (CBT). This is inconsistent with evidence collating individual patient data (IPD) from multiple randomised controlled trials (RCTs).1 IPD meta analyses are one way of increasing statistical...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Lewis, G., Lewis, G. Tags: Clinical trials (epidemiology), Depressive disorder, Epidemiology Psychological interventions Source Type: research
Metoclopramide may be effective for clozapine-induced hypersalivation
ABSTRACT FROM: Kreinin A, Miodownik C, Mirkin V, et al. Double-blind randomized, placebo-controlled trial of metoclopramide for hypersalivation associated with clozapine. J Clin Psychopharmacol 2016;36:200–5. What is already known on this topic Clozapine-induced hypersalivation is the most prevalent adverse effect experienced by patients treated with clozapine and negatively impacts on quality of life,1 with symptoms particularly prevalent at night-time. Pharmacotherapeutic strategies employed to date, based on multiple mechanisms including antimuscarinic agents and α-2 agonists have largely been associated wit...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Hallahan, B. Tags: Clinical trials (epidemiology), Neurology, Schizophrenia spectrum, Epidemiology Pharmacological interventions Source Type: research
Routine use of antipsychotics to prevent or treat delirium is not recommended
ABSTRACT FROM: Neufeld KJ, Yue J, Robinson TN, et al. Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: a systematic review and meta-analysis. J Am Geriatr Soc 2016;64:705–14. What is already known on this topic The American Geriatrics Society has developed guidelines to respond to the question of whether the use of antipsychotic medications in the perioperative period to prevent or treat delirium in older adults is supported by scientific evidence.1 2 Although the focus was on older adults after surgery, the panel raised concerns that the existing literature was too limited. T...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Kishi, T. Tags: Clinical trials (epidemiology), Epidemiologic studies, Neurology, Delirium, Drugs: psychiatry, Epidemiology Pharmacological interventions Source Type: research
Perinatal suicide associated with depression diagnosis and absence of active treatment in 15-year UK national inquiry
ABSTRACT FROM: Khalifeh H, Hunt IM, Appleby L, et al. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry 2016;3(3):233–42. What is already known on this topic Perinatal suicide is a rare but tragic complication of pregnancy and childbirth with significant public health implications.1 Among women with psychiatric illness, prior research suggests that suicide risk may be increased as much as 70-fold if compared with the general population.2 Beyond this, little is known about risk factors for completed suicide among perinatal ...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Kim, J. J., Silver, R. K. Tags: Epidemiologic studies, General practice / family medicine, Suicide (psychiatry), Epidemiology Outcomes Source Type: research
Prevention and treatment of mental health crises: examining the gaps in the evidence base
ABSTRACT FROM: Paton F, Wright K, Ayre N, et al. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care. Health Technol Assess 2016;20:1–162. What is already known on this topic From a services’ perspective, a mental health crisis is a behavioural change that brings the service user to the attention of crisis services, for example, through relapse of a mental health condition.1 Preventing and supporting mental health crises is a priority in many jurisdictions plagued by fragmentation of health, community and social services, inequities in access and...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Stergiopoulos, V. Tags: Emergency medicine, Bipolar disorder Outcomes Source Type: research
PTSD is associated with elevated inflammation: any impact on clinical practice?
ABSTRACT FROM: Passos IC, Vasconcelos-Moreno MP, Costa LG, et al. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. Lancet Psychiatry 2015;2:1002–12. What is already known on this topic Accumulating evidence indicates that elevated inflammation may play a causal role in the development of post-traumatic stress disorder (PTSD) symptoms, and in PTSD-related increased risk for cardiovascular, autoimmune and neurodegenerative diseases.1 2 At the same time, studies examining levels of inflammatory markers in individuals with PTSD have had mixed results, with m...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: O'Donovan, A. Tags: Epidemiologic studies, Neurology, Post-traumatic stress disorder, Depressive disorder, Epidemiology Causes and risk factors Source Type: research
Which psychotherapy for PTSD?
Clinical casePatient: 21-year-old man Present illness: The patient was 8 years old, when the Great Hanshin Earthquake hit the city of Kobe, Japan and killed some 6500 persons and injured 44 000 persons (https://en.wikipedia.org/wiki/Great_Hanshin_earthquake). Although the patient's house was shattered, all his family was safe and alive. However, he had many friends at school and some relatives who were killed. In particular, one of his best friends was lost. He recalls that he was despondent for a few years but gradually started living a normal life for a young boy. He graduated from primary school, junior high s...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Furukawa, T. A. Tags: Emergency medicine, General practice / family medicine, EBMH Evidence-Based Case Conference, Nursing, Post-traumatic stress disorder Source Type: research
Designing and analysing clinical trials in mental health: an evidence synthesis approach
Conclusions
In the presence of reliable and relevant evidence, the design offers a way to conduct a smaller study without compromising power. It therefore fills a gap between the assessment of evidence and its actual use in the design and analysis of studies. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Wandel, S., Roychoudhury, S. Tags: Editor's choice, EBMH Statistics in Practice, Schizophrenia spectrum Source Type: research
Driving and dementia: a clinical update for mental health professionals
Most people with mild dementia can continue to drive, but dementia is progressive and many patients and clinicians will be faced with questions about driving safety in the course of their illness. Determining when this happens is a complex decision, with risks of personal and public safety needing to be weighed against individual patient benefits of driving in terms of autonomy, independence and well-being. Decisions need to make reference to cognitive abilities, as well as other factors including physical comorbidity, vision, mobility, insight and history of driving errors and accidents. Deciding to stop driving, or being...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Allan, C. L., Behrman, S., Baruch, N., Ebmeier, K. P. Tags: Editor's choice, Neurology Clinical review Source Type: research
Assessing and measuring cognitive function in major depressive disorder
Cognitive dysfunction is a major component of major depressive disorder (MDD). No ‘gold-standard’ tool exists for the assessment of cognitive dysfunction for adults with MDD. The use of measurement-based care to improve treatment outcomes invites the need for a systematic screening, evaluation and measurement tool. The aim herein was to provide a succinct summary of literature documenting clinical implication of cognitive dysfunction in MDD, and a review of available screening, diagnostic and measurement tools for cognitive dysfunction in MDD is provided. We also take the opportunity to introduce a screening to...
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Ragguett, R.-M., Cha, D. S., Kakar, R., Rosenblat, J. D., Lee, Y., McIntyre, R. S. Tags: Neurology, Depressive disorder, Epidemiology, Screening (epidemiology) Clinical review Source Type: research
Exercising control over bipolar disorder
This article discusses recent research findings and provides an overview of the extant literature related to the neurobiological underpinnings of BAS and exercise as they relate to bipolar disorder. This is important clinically because depending on mood state in bipolar disorder, we postulate that exercise could be either beneficial or deleterious with positive or negative effects on the illness. Clearly, this complicates the evaluation of exercise as a potential treatment in terms of identifying its optimal characteristics in this population. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - October 20, 2016 Category: Psychiatry & Psychology Authors: Malhi, G. S., Byrow, Y. Tags: Editor's choice, Neurology, Bipolar disorder, Depressive disorder Clinical review Source Type: research
