Reading of the Week: Drs. Maunder and Hunter’s New Book

August 20, 2026 / / 0 Comments

From the Editor

We are going to teach you how to keep your head above water while you manage your complicated life, even when it feels overwhelming. Writing a book that teaches how to cope, however, feels like a monumental act of hubris. Ask our partners, friends, or kids, and they will tell you that our confidence that we can add value to your struggle, whatever it is, is not based on our having any innate coping superpowers. Rather, we know the evidence, and we have learned how to teach it.

Drs. Robert Maunder and Jonathan Hunter, psychiatrists affiliated with the University of Toronto, open their new book with this comment.

It’s a complicated world, and some people struggle. The authors try to answer a question that is both ordinary and profound: What can we do when life becomes overwhelming? Drs. Maunder and Hunter’s new book, Coping: Fix Problems, Find Meaning, Feel Better, is intended for a general audience and points a way forward, with an optimistic tone, hundreds of citations, and clear advice. The book is about coping. It’s also about trauma, adversity, and finding strength.

This week, there is only one selection: an excerpt from their new book, chosen by the authors.

How should we think about this work? At some level, it’s a really smart self-help book, offering clear suggestions on important topics. How can we sleep better? Page 87 offers tips, drawing on CBT-I. There is also discussion of box breathing (p. 102), cutting back on device time (p. 157), and more. 

The book isn’t just about living better – it’s about acknowledging that some are living through extraordinary circumstances. They open by talking about working with patients and providers during the SARS outbreak. The book includes interviews with patients. They also discuss deeper topics like CBT and DBT. At points, the book touches on philosophy; the excerpt that follows includes a discussion of Nietzsche.

The book’s central ideas are simple: fix what you can; feel better about what you can’t fix; and, when suffering persists, live meaningfully.

Thus, the book is really a break from the typical self-help books that populate the shelves of bookstores. They don’t peddle glib recommendations, such as the need to start every day by making your bed. They instead tap the literature and offer good – though not necessarily easy – advice. Coping is ultimately less a promise to make life easier than an invitation to develop a better toolkit to deal with adversity. “Coping as fully and as effectively as you can with all the adversity that is inevitable in your life will reveal who you are.”

During the pandemic, patients would often ask about maintaining mental health during social isolation – as did friends and family. Rowan Diamond and Dr. John Willan (both of Oxford University) wrote a short paper for The British Journal of Psychiatry that I often mentioned, outlining several strategies that could help. Reading Coping, I thought about those conversations – and I thought about incorporating the Maunder-Hunter suggestions into my discussions with patients now; I also thought about the patients to whom I could recommend the book. Frankly, many would benefit.

Of course, this raises a larger question: At a time when we speak more about mental health, why are we collectively doing so badly? Studies suggest that people are more anxious and depressed, feel more isolated, and rate their mental health as poorer. National data finds more homelessness, drug misuse, and workplace absenteeism. In terms of coping, then, we seem to be getting a failing grade. Drs. Maunder and Hunter touch on this topic – we live in “impossible times,” they write in the last chapter. Perhaps we will need to wait for their next book to have a better understanding of how we got here.

In the meantime, Coping is an excellent book on an important topic.

A special word of thanks to the University of Toronto Press for making this Reading possible.

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

DG


Continue reading

Reading of the Week: Measurement-based Care – the New Psych Services Paper; Also, Agentic AI, and Dr. Johari on Losing a Patient

August 13, 2026 / / 0 Comments

From the Editor

Studies show that measurement-based care improves patient outcomes, from better functioning to fewer readmissions. Not surprisingly, expert practice guidelines, including the CANMAT clinical guidelines for depression, recommend their use. Yet – despite years of enthusiasm – most of us don’t use scales or questionnaires to monitor symptoms and outcomes.

In a new systematic literature review, Christian Burr (of the Bern University of Applied Sciences) and his co-authors try to identify effective strategies by analyzing recent studies. In their Psychiatric Services paper, they focused on 16 studies in a systematic literature review. “Effective measurement-based care implementation requires context-sensitive strategies, interprofessional collaboration, and active involvement of patients, service users, and caregivers.” We consider the paper and its implications.

In the second selection from The British Journal of Psychiatry, Dr. Scott Monteith (of Michigan State University) and his co-authors write about the evolution of artificial intelligence. They focus on agentic AI (arguably the next big thing), seeing a clear role in education, yes, and in patient care – but they also note problems. “Agentic artificial intelligence systems offer a unique approach to supporting physicians in dealing with the challenges of clinical medicine but also pose validity, privacy, malpractice and security risks.”

And in this week’s final selection, Dr. Paniz Johari, a psychiatrist who works at Northwell Health, writes personally and thoughtfully about the loss of her patient to suicide. In JAMA, she discusses her grief and rumination. “The absence of anything remarkable made it harder to understand and harder to set aside.”

DG

Continue reading

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 /

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.”

DG

Continue reading

Reading of the Week: Social Media Likes & Depression – the New JAMA Psych Paper; Also, Dr. Taglienti on Being Noticed

July 30, 2026 /

From the Editor

When you post a cute picture of your baby cousin on social media, you receive many likes and feel encouraged to post more. To speak technically, drawing on reinforcement learning, social rewards reinforce posting. But how do people with depression respond to social media? Would they be less motivated by reinforcement learning (consistent with past work)? Could platforms like Twitter (now X) actually worsen depression?

In a new JAMA Psychiatry study, Dan-Mircea Mirea (of Princeton University) and his colleagues attempt to answer these questions. They analyzed 17 million posts from almost 8 000 Twitter users to test the association between depression and the tendency to be reinforced by likes. “In this cross-sectional study, we found that individuals with depressive psychopathology showed a greater tendency to be reinforced by likes on Twitter.” We consider the paper and its implications; we also look at the accompanying Editorial.

And in this week’s other selection, from JAMA, Dr. Jenna Taglienti (of Hofstra University) writes about a resident who misses a call shift. As the residency program director, she thinks on their conversation – and on being noticed. She recalls the loss of her mother. “I think about my mother labeling photographs and childhood keepsakes long before any of us were ready to imagine needing them.”

DG

Continue reading

Reading of the Week: Therapy, with Papers on Long-Term Effects and on Pet Therapy; Also, Lieberman on Too Much Therapy

July 16, 2026 /

From the Editor

Patients with depression benefit from psychotherapy. But do those effects last?

The question isn’t new, but long-term effects haven’t been well studied. An impressive new World Psychiatry study by Pim Cuijpers (of Vrije Universiteit Amsterdam) and his co-authors brings needed data to the discussion. They did a meta-analysis of 191 RCTs with 209 comparisons between treatment and control groups, involving 33 691 participants. “We conclude that psychotherapies have moderate to large effects at 3 months after randomization, which slowly decrease during the next 9 months to a moderate level, and remain stably moderate for several years.” We consider the paper and its implications.

In the second selection, from The American Journal of Psychotherapy, Michelle Geiss (of Southern Illinois University) and her co-authors analyzed a canine-assisted intervention (CAI) on an inpatient unit, drawing on semi-structured interviews with 17 psychiatric nursing staff members. “CAI was perceived by staff as a valuable complementary therapy in the inpatient psychiatric setting, offering emotional, social, and therapeutic benefits for both patients and staff.”

And in the third selection, psychologist Harvey Lieberman reflects on psychotherapy in an essay for The New York Times. As a therapist, he wonders whether too many people seek therapy. “For some people, therapy can help in ways nothing else can. But many will find that the best forms of understanding and emotional support flow from informal networks of relatives, neighbors and friends, not the health care system.”

Note: there will be no Reading next week.

DG

Continue reading

Reading of the Week: Doctors & Suicidality – the New CMAJ Study; Also, GLP-1 RAs & Eating Disorders, and Chin-Yee on the Death of the Consult Note

July 9, 2026 /

From the Editor

His suicidal thoughts were so strong that he had written a suicide note. Yet, during the months before we met in the ED, he had hesitated to seek care. As a doctor, he knew he had severe depression but he told me that he felt he couldn’t get help. 

Such stories are all too common. In a CMAJ study, Dr. An Yi (Annie) Yu (of the University of Toronto) and her co-authors shed light on physicians’ seeking help for suicidality. They drew from the literature (literally): analyzing 52 narratives from academic papers, finding various barriers to seeking care, including aspects of medical culture, and identified facilitators, such as confidential services. “The pressure to achieve in medicine often discourages physicians from acknowledging their need for help, but the value of meaningful work emerged as a positive factor for mental health. The stigma regarding mental health concerns was substantially reduced through role modelling of help-seeking behaviour by colleagues.” We consider the study and its implications.

GLP-1 receptor agonists are having a moment because of the evidence for diabetes and other conditions. In the second selection, Nicholas C. Peiper (of the University of Louisville) and his co-authors focus on those with eating disorders, analyzing data to understand use and misuse in a new JAMA Psychiatry research letter. “This cross-sectional study found that GLP-1 RA use and misuse were common in a targeted sample of people with eating disorders.”

And in the third selection, from JAMA, Dr. Benjamin Chin-Yee (of Western University) writes about consult notes. He wonders what is lost in the “digital transformation” of templates and AI scribes. He worries about the future of the consult note. “The tools may evolve, but the art of pausing, thinking, and telling a story is still ours to preserve.”

DG

Continue reading

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

July 2, 2026 /

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.”

DG

Continue reading

Reading of the Week: Suicide – Papers from BJPsych & Lancet Psychiatry, and Dr. Mark Sinyor on Prevention

June 25, 2026 /

From the Editor

“Media reports about suicide have the potential to influence suicide rates. Most research in this area has focused on increased rates of suicide that follow widely reported stories of suicide death, often in celebrities, the so-called Werther effect. However, a small and growing literature has investigated the Papageno effect in which widely disseminated stories of mastery of suicide crises and survival are followed by fewer suicides.”

So opens a fascinating paper recently published in The British Journal of Psychiatry. In it, Sangsoo Shin (of the University of Melbourne) and her co-authors look at a highly publicized news story: the singer Jon Bon Jovi intervening to stop a woman’s suicide attempt in 2024. Was there a Papageno effect? The authors analyzed suicide mortality data spanning a decade in Tennessee and 19 other states with 60 subgroups. “This study provides the first evidence of a Papageno effect following a widely publicised, real-life survival story.” We consider the paper and its implications.

Suicide prevention has come a long way since the SAD PERSONS mnemonic that many of us learned in medical school. And the research continues to evolve. What to make of it all, and how should the latest research inform practice? In the second selection, an episode of Quick Takes, I speak with Dr. Mark Sinyor, professor at the University of Toronto and staff psychiatrist at Sunnybrook Health Sciences Centre. We discuss the efficacy of suicide-prevention barriers (think the Bloor Viaduct here in Toronto) and restricting highly lethal pesticides. “You don’t actually need billions of dollars to prevent suicide. You just need really good coordination.”

In the third selection, from Lancet Psychiatry, a medical student discusses her suicidal thoughts. The paper – which is written anonymously – argues that many providers take the wrong approach when speaking to patients who are suicidal. “All I am saying is, if medicine placed the same emphasis on healing as it does on survival, I believe our approaches would change and perhaps our outcomes would improve as well.”

DG

Continue reading

Reading of the Week: Help-seeking & Gambling – the New CMAJ Study; Also, Women With Schizophrenia, and Dr. Campo on Patients & Faith

June 18, 2026 /

From the Editor

Can Argentina repeat? Could England end its six-decade drought? Roughly five billion people will watch this year’s World Cup. The tournament can be understood in different ways: a great sporting event, a giant party, and, yes, a huge draw for gamblers. In Ontario – and across North America – recent laws have dramatically expanded gambling options. How have such changes affected problem gambling and the need for help? 

In a new CMAJ study, Ryan Forrest (of the University of Toronto) and his co-authors attempt to answer that question. They drew on Ontario data to quantify the increase in help-seeking following the launch of a government-operated online gambling platform in January 2015 and the subsequent expansion of private online gambling. They analyzed almost 750 000 contacts to a helpline over 13 years, finding that the mean monthly rate of gambling-related contacts nearly doubled. “The rapid expansion and privatization of online gambling, including single-event sports betting, in Ontario were respectively associated with marked increases in gambling-related helpline contacts, specifically among adolescent boys and young men.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Laura M. Rowland (of the University of Maryland) and Dr. Ellen E. Lee (of the University of California San Diego) write about schizophrenia and women. “The lack of focused health research on women in general is well recognized, and mental health research remains no exception. Surprisingly, there is also a lack of mental health research on older people with schizophrenia with less than 5% of scientific publications on schizophrenia dedicated to this older group.”

Finally, in the third selection, Dr. John V. Campo (of Johns Hopkins University) discusses faith and psychiatry. In a personal essay for The Washington Post, he notes his own religious experience and declining health. “Taking our patients seriously requires physicians to explore issues of ultimate concern, suggesting that a spiritual history should be an expected component of any comprehensive clinical evaluation.”

DG

Continue reading

Reading of the Week: Trauma & Schizophrenia – the New AJP Study; Also, AI Chatbot & US Teens, and Gunther on the Blessings & Curses of Meds

June 11, 2026 /

From the Editor

Can a parent’s trauma influence the development of mental illness in his or her child? Research suggests an intergenerational link for several disorders, including PTSD. But what about schizophrenia? Complicating such research: the complexity of genetics, environment, and trauma – and the limits of data.

In a new American Journal of Psychiatry paper, published last week, Iaroslav Youssim (of the Hebrew University of Jerusalem) and his co-authors attempt to answer these questions by looking at parental exposure to the Holocaust – years before conception – and the associated risk of schizophrenia in their children. They drew data from 92 000 births in West Jerusalem between 1964 and 1976. “Offspring of mothers who were older than age 5 when Nazi persecutions began showed over a twofold increase in schizophrenia risk, underscoring the potential impact of trauma and its timing during the preconception period in the pathogenesis of schizophrenia.” We consider the study and its implications.

How often do adolescents and young adults use AI chatbots for mental health? In the second selection, from JAMA Pediatrics, Ryan K. McBain (of RAND) and his co-authors report on a US survey. They find that one in five youth use AI chatbots for mental health advice. “AI chatbots are already embedded in many youths’ mental health information ecosystem, underscoring the need for parents and clinicians to proactively discuss chatbot use to promote safety, appropriate expectations, and linkages to evidence-based care.”

And in the third selection, Sarah M. Gunther discusses medications and her journey in Psychiatric Services. In her personal essay, she describes trying different meds over time and the problems that they caused. She finally lands on the right combination. “I tell this story so that others won’t give up, and so doctors can see that the medications that they prescribe can make an illness worse.”

DG

Continue reading