“Putting the Efficacy of Psychiatric and General Medicine Medication Into Perspective” AND More on Best 5 Wednesday Reads

Hello and welcome to another edition of Best 5 Reads. Lets begin!

1) Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses

Background

The efficacy of psychopharmacological treatments has been called into question. Psychiatrists are unfamiliar with the effectiveness of common medical drugs.

Aims

To put the efficacy of psychiatric drugs into the perspective of that of major medical drugs.

Method

We searched Medline and the Cochrane Library for systematic reviews on the efficacy of drugs compared with placebo for common medical and psychiatric disorders, and systematically presented the effect sizes for primary efficacy outcomes.

Results

We included 94 meta-analyses (48 drugs in 20 medical diseases, 16 drugs in 8 psychiatric disorders). There were some general medical drugs with clearly higher effect sizes than the psychotropic agents, but the psychiatric drugs were not generally less efficacious than other drugs.

Conclusions

Any comparison of different outcomes in different diseases can only serve the purpose of a qualitative perspective. The increment of improvement by drug over placebo must be viewed in the context of the disease’s seriousness, suffering induced, natural course, duration, outcomes, adverse events and societal values.

2) How can we expect borderline personality disorder patients to trust mental health services when the staff don’t trust them?

Establishing trust is a huge ask for patients who have experience damage at the hands of others. Yet we punish psychiatric patients by giving them a label that enables others to carry on treating them like dirt

3) The power of digital tools to transform mental healthcare

International organizations are redoubling their efforts on this issue. Forward-thinking members of the World Economic Forum’s Global Future Council on Neurotechnologies recently convened to explore the many ways that rapid advances in telecommunications, big data analytics (including machine learning), mobile technologies and biosensors – loosely grouped together under the umbrella term “digital technologies” – are poised to have a profound impact on diverse aspects of mental healthcare and treatment. Digital technologies are becoming increasingly available worldwide and will only continue to advance. Those that relate to our understanding of the brain and behaviour may have a particularly important role to play in improving mental health outcomes.

At their most basic, such interventions could include straightforward telepsychiatry applications. These can deliver care effectively in areas with a low density of mental health professionals, using “remote psychiatrist” videoconferences and low-bandwidth text/SMS services to send medication and appointment reminders, and disseminate information around mental health.

4) Child abuse linked to risk of suicide in later life

Children who experience physical, sexual, and emotional abuse or neglect are at least two to three times more likely to attempt suicide in later life, according to the largest research review carried out of the topic.

5) Jury Out on EEG to Predict Depression Treatment Response

There is currently insufficient evidence to recommend quantitative EEG in routine clinical practice to guide choice of treatment for depressive illness, researchers say.

Thank you and see you tomorrow for more articles!

Best Regards,

Vikram