Reading of the Week: MST vs ECT for Bipolar Depression – the New AJP Study; Also, Unhappiness & Psychiatry, and Thorpe on Her Postpartum Psychosis

November 12, 2026 / / 0 Comments

From the Editor

The manic episodes had been destructive, if short-lived, damaging her relationships and leaving her in debt. But the depressive episodes sat on her for years, leaving her demoralized and feeling hopeless. Will I ever get better? Like many, my patient found that bipolar depression could be hard to treat. She hesitated on ECT, worrying about the cognitive effects. 

Is there an alternative? In a new American Journal of Psychiatry paper, Dr. Daniel M. Blumberger (of the University of Toronto) and his colleagues attempt to answer that question. They report on a double-blind, randomized, parallel-group pilot clinical trial comparing ECT and magnetic seizure therapy (MST), a newer neuromodulation technique that uses a magnetic field to induce a seizure. The study included 55 people. “Relative to ECT, MST demonstrated similar clinical outcomes and greater cognitive safety.” We consider the study and its implications.

Daniel M. Blumberger

In the second selection, Dr. Carlos De las Cuevas (of the University of La Laguna) wonders if psychiatry is becoming “the science of unhappiness.” He worries that it is. “Poverty, injustice and loneliness shape mental health, but they are not mental illnesses. At the same time, clinicians cannot bracket out the social world from their practice, nor should they.”

And, in the third selection, Hilary Thorpe writes about postpartum psychosis in The Globe and Mail. The essay is personal, drawing on her experiences with the illness and her recovery. “Lindsay Clancy’s story reminds me how close my life came to going another way, and how fortunate I am that I got help when I needed it.”

Note: There will be no Reading for the next two weeks.

DG

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Reading of the Week: Public Policy & Mental Health – Daylight Saving Time (CMAJ) & Opioids (JAMA); and Lopez on Wyoming & Suicides

November 5, 2026 / / 0 Comments

From the Editor

This week, the three selections look at the intersection of mental health and public policy.

With daylight saving time ending, many North Americans set their clocks back an hour this past Sunday morning, seemingly gaining an extra hour. But several jurisdictions have ended “spring forward, fall back,” instead choosing permanent daylight saving time. What are the effects on mental and physical health? In the first selection, Dr. Raymond W. Lam (of the University of British Columbia) and his co-authors attempt to answer that question with an impressive CMAJ paper with 42 references and two tables. “Ending biannual clock adjustments may eliminate transition harms that last a few weeks, but the health effects of permanent time are likely to be chronic.”

In the second selection, a research letter published in JAMA, Dr. Lyna Z. Schieber (of the Centers for Disease Control and Prevention) and her co-authors analyzed US pharmacy data to better understand opioid dispensing in recent years. They report some good news, in part because of federal and state legislative changes: “Opioid dispensing continued to decline through 2025, extending more than a decade-long downward trend in the United States since its peak in 2012.”

Finally, in the third selection, German Lopez writes about suicides in Wyoming in the New York Times. His excellent essay describes a state facing a major problem: its suicide rate is double the US national average. He writes about the different people he has met, noting a general reluctance to talk about mental health. He also describes legislative reforms that would help. “If the state wants to lose its status as one of the worst for suicides, something has to change.”

DG

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Reading of the Week: Task-sharing & Perinatal Health – the New Lancet Obs Study; Also, Regulations & AI and Dr. Saddawi-Konefka on Bravery

October 29, 2026 /

From the Editor

Last year, Daisy Singla (of the University of Toronto) and her co-authors published an important paper on perinatal care. The SUMMIT trial borrowed a page from experiments in low-income countries where – with few providers – non-specialists have been trained up for some psychotherapies. There may be a great distance between rural India and the urban North American centres participating in SUMMIT, but Singla et al. showed impressive results at three months for those with perinatal depression. 

But do the benefits continue after those first months? In this week’s first selection, a new paper from The Lancet Obstetrics, Gynaecology, & Women’s Health, Singla et al. attempt to answer that question with a secondary analysis. “Behavioural activation for perinatal depression produced sustained improvements over the 12 months since randomisation when delivered by non-specialist providers… with similar clinical outcomes and favourable economic value relative to specialist delivery.” We consider the paper and its implications.

In the second selection, Dr. William Smith (of the University of North Carolina at Chapel Hill) and his co-authors look at AI and regulations in a new Viewpoint published in JAMA Psychiatry. As AI’s role in mental health grows, they review current US state and federal government regulations. “Emerging federal and state regulatory approaches remain vague and are sometimes conflicting.”

Finally, in the third selection, Dr. Daniel Saddawi-Konefka (of Harvard University) writes about depression and stigma. The JAMA paper is personal – he describes his own experiences. He also notes that disclosing mental illness is often considered brave. “My wish is duller still, a world where getting help for your mind is as ordinary as filling your car’s gas tank.”

DG

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Reading of the Week: Suicide in Canada; Also, School Cellphone Restrictions and Uebel on Irritability

October 22, 2026 /

From the Editor

This week, we turn closer to home. All the selections are from The Canadian Journal of Psychiatry. The Canadian connection includes the journal, of course, as well as the data and topics. That said, these topics – suicide, school cellphone restrictions, and irritability – are relevant for those in my home country and elsewhere.

In the first selection, Sara Zulyniak (of the University of Calgary) and her co-authors look at suicide trends in Canada from 2000 to 2024, drawing on Statistics Canada data. “Overall trends and many Canadian age and sex groups have seen declining rates of suicide mortality beginning in 2018, though some young female groups have continued to have increasing rates of suicide from 2000 to 2024.” We consider the paper and its implications.

In the second selection, Kimberley C. Tsujimoto (of the Hospital for Sick Children) and her co-authors analyzed data on the early implementation of school cellphone restrictions in Ontario and the association with screen use and mental health outcomes for children and youth. “We found that greater adherence to school cellphone restrictions was associated with lower social media use, and subsequently fewer depressive and anxiety symptoms.”

In the third selection, Michael Uebel (of The University of Texas at Austin) writes about irritability in depression and anxiety. “Irritability carries information that standard depression scales miss, and that tracking it offers an early, actionable read on whether to continue or modify a treatment.”

DG

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Reading of the Week: AI Psychosis – from JAMA Psychiatry; Also, Benzodiazepines in the US, and Dr. Belay on Social Media & Symptoms

October 15, 2026 /

From the Editor

ChatGPT is the most downloaded app in history. People turn to AI for travel tips and restaurant advice. But what about its impact on those vulnerable to psychosis? Or those experiencing psychosis?

In a new research letter published in JAMA Psychiatry, Zachary Bergson (of Vanderbilt University) and his co-authors attempt to answer those questions by analyzing more than 200 000 mental health notes at an academic centre. “In this systematic analysis of AI psychosis, documented in the EHR of a large US medical setting, psychosis-worsening interactions with conversational AI were most common among patients experiencing their first episode of psychosis.” We consider the study and its implications.

In the second selection, from The American Journal of Psychiatry, Naomi Cruz (of Rutgers University) and her co-authors look at benzodiazepine dispensing in the United States, using data on 1.1 billion prescriptions. “From 2013 to 2024, the national prevalence of dispensed benzodiazepine prescriptions declined by more than one-quarter, with reductions across all patient age groups and most prescriber types as well as in the mean dose dispensed per benzodiazepine prescription.”

And in the third selection, from The Washington Post, Dr. Nebyou Belay, a psychiatrist, writes about the influence of the Internet on psychiatric diagnoses. He argues that social media can encourage people – particularly young people – to adopt psychiatric diagnoses before their symptoms have been properly assessed, blurring the line between normal distress and mental illness. “Psychiatry should help people understand what they are experiencing. Increasingly, however, the Internet gets there first.”

DG

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Reading of the Week: Cannabis – With Papers from Lancet Psych and JAMA Psych; Also, Dr. Kaliamurthy on How the Weed Got Too Strong

October 8, 2026 /

From the Editor

Cannabis was the only thing that helped him sleep, my patient explained. He also described positive information he had found online. He then asked: Will it affect my psychosis?

In a new review published in The Lancet Psychiatry, Wayne Hall (of The University of Queensland) and his co-authors look at cannabis use and major mental disorders. The topic isn’t new, of course, but their approach is impressive: they draw on many types of studies (epidemiological, genetic, experimental, and preclinical) to try to establish the connection – or the lack of connection – between daily cannabis use and psychosis, bipolar disorder, anxiety, and depression. “There is credible evidence that regular cannabis use plays a contributory causal role in psychosis.” We discuss the paper and its implications.

How have cannabis and alcohol misuse changed over time? In the second selection, from JAMA Psychiatry, Beth Han (of National Institutes of Health) and her co-authors use a US dataset with almost 190 000 participants, and show a sharp rise in cannabis use disorder. “More effective cannabis use disorder treatments are needed.”

Finally, in the third selection, Dr. Sivabalaji Kaliamurthy (of Howard University) writes about cannabis in an essay for The New York Times. He notes a big increase in the potency of cannabis and describes his worries as a physician, particularly about adolescent users. “The question now is whether we are willing to regulate and enforce product safety, especially to protect the most vulnerable among us.”

DG

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Reading of the Week: New Tech for Old Problems? An App for Negative Symptoms, Chatbots & Suicidality, Notes in the Age of AI Scribes

October 1, 2026 /

From the Editor

The voices became quieter, and the paranoia lessened. But my patient continued to complain about his lack of motivation. He left the hospital, but he never rejoined the workforce. Negative symptoms are difficult to treat.

Could an app help? In a new JAMA Network Open paper, Abhishek Pratap (of Boehringer Ingelheim Pharmaceuticals) and his co-authors attempt to answer that question. They describe a randomized clinical trial of 457 individuals with negative symptoms of schizophrenia, comparing those receiving an app (CT-155) intervention featuring evidence-based psychosocial treatments against an active control. “These findings support CT-155 as a potential adjunctive therapy for patients for an indication of negative symptoms of schizophrenia with a high unmet need for FDA-approved pharmacologic treatments specifically targeting negative symptoms.” We discuss the paper and its implications.

As more and more people turn to chatbots for mental health advice, we should ask: how can we make them safer? In a new Comment from npj Digital Medicine, Joanna M. Streck (of Harvard University) and her co-authors describe experimentation with an AI chatbot and the lessons learned. “We describe suicide safety monitoring features for a chatbot implemented in a high-risk clinical setting and make recommendations for chatbot design alongside human-monitoring and triage.”

Finally, in the third selection, Dr. Danilo Rojas-Velasquez (of Harvard University) writes about clinical notes and language in a paper for Academic Psychiatry. He offers suggestions for learners, noting how language affects care – a topic now even more relevant with the growing use of AI scribes. “We watch language do its quiet work, and we write notes that will, in turn, shape how the next team thinks.”

DG

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Reading of the Week: Will the Doctor See You Now? Video vs In-Person Visit Outcomes; Also, Suicide Prevention in India and Barford on Fake Patients

September 24, 2026 /

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, establishing partnerships in seven countries and promotional arrangements in three more.  

A quick word of thanks for your ongoing interest.

In March 2020, mental health services were transformed by the reality of the pandemic and the webcam became indispensable. Today, many clinical programs offer a mix of video, in-person, and phone visits. But what are the outcomes?

In a new JAMA Network Open paper, Samantha L. Connolly (of Harvard University) and her co-authors attempt to answer that question. Using Veterans Affairs’ data involving 813 699 participants, they compared different modalities of care and looked at outcomes over a year, including inpatient admissions. “In this comparative effectiveness study, receiving mental healthcare via video was associated with improved clinical outcomes compared with receiving care via phone or in-person.” We consider the paper and its implications.

In the second selection, Rakhi Dandona (of the Public Health Foundation of India) and Dr. Rajesh Sagar (of the All India Institute of Medical Sciences) write about suicide prevention in JAMA Psychiatry. They offer lessons from India, where one in five suicides occur. “If most suicides occur in LMICs, then the future of suicide prevention should increasingly be shaped by evidence generated within them.”

And in the third selection from The Globe and Mail, Pat Barford writes about being a “fake patient,” to use her term. She describes her work as a standardized patient for medical students. “I get to watch the highest level of learning happen in real-time.” 

DG


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Reading of the Week: Economic Burden of Depression – the New Nature Med Study; Also, AI & Delusions and Dr. Garfinkle-Crowell on Young Women

September 17, 2026 /

From the Editor

This month, Reading of the Week celebrates its 12th anniversary. Over these past years, the program has grown, with partnerships in seven countries and promotion in three more.  

A quick word of thanks for your ongoing interest.

We usually think about depression on the individual level – our patients tell stories of lost jobs, broken relationships, and personal tragedies. But what are the societal costs? In a new Nature Medicine paper, Zhong Cao (of Heidelberg University) and his co-authors attempt to answer that question. They analyzed World Bank data; using labour force participation, education, and work experience, they projected the global economic burden of depression to 2050. “Overall, depression places a heavy strain on the global economy, accounting for about 0.460% of the world’s annual GDP. This burden, however, is uneven across regions.” We consider the paper and its implications.

In the second selection, from JAMA Psychiatry, Philip R. Corlett (of Yale University) weighs in on AI and psychosis in a new commentary. Does AI cause psychosis? Does it exacerbate problems for those who are vulnerable? Corlett reviews this young literature and offers his thoughts. “I suspect that they are not merely old wine in new bottles, but rather new wine in new bottles.”

Finally, in the third selection, Dr. Suzanne Garfinkle-Crowell (of the Icahn School of Medicine at Mount Sinai) writes about therapy-speak and young women for The New York Times. She describes the trend and its implications – and warns against dismissing it. “Ideally, we should create an environment in which girls can stop blaming their own brains for every problem and where they don’t feel they have to be sick to be heard.”

DG

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Reading of the Week: Psychosocial Care After War – The New Lancet Psych Paper; Also, AI vs Physicians (JAMA) and the Latest in the News

September 10, 2026 /

From the Editor

He survived the civil war. But nightmares haunted him and he rarely left his apartment. My patient had survived, yes, but his mental health problems, untreated in his home country, tormented him. In a world of war and violence, my patient’s experiences – the mental illness and the lack of care – are all too common. 

With few psychiatrists and psychologists, could non-specialist providers help fill the treatment gap? Anushka R. Patel (of Harvard University) and her co-authors attempt to answer that question in an impressive new systematic review and meta-analysis published in Lancet Psychiatry. Drawing on a quarter century of studies and involving more than 10 000 survivors, they compared non-specialist care with a relatively inactive control. “Our findings support the overall effectiveness of non-specialist provider-delivered psychosocial interventions for violence survivors…” We consider the paper and its implications.

In the second selection, from JAMA, Dr. Ezekiel J. Emanuel and his co-authors write thoughtfully if controversially about artificial intelligence. While many assume that medicine will be reshaped by the collaboration of physicians and computers, they suggest otherwise, focusing on five cognitive medical tasks. “That in the near future AI alone may provide better patient care than physicians or physician-controlled hybrids at 5 fundamental cognitive medical tasks is unsettling but seems probable.”

Finally, we review the latest news with articles from The Toronto Star, The Wall Street Journal, and The Globe and Mail. The topics: addiction treatment, the bias of therapists, and the PTSD and research of Margaret McKinnon.

DG

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