November 25, 2014
An article was recently published in The Lancet Psychiatry and nicely summarized in Forbes describing the benefits of even short-term psychotherapy on repeated suicide attempts and suicide related deaths. Not surprisingly, the data suggest that talk therapy serves to significantly reduce the frequency of suicide following a previous suicide attempt. The Forbes article also very briefly summarized several recent studies on the efficacy of psychotherapy as an adjunct to or instead of psychiatric medication.
November 11, 2014
For the past decade some of the “newer” antidepressants have had “black box warnings” that caution about a risk of suicidal thoughts and behaviors in young adults and kids. Though there has been controversy about this, the benefits and risks of these easily misinterpreted warnings is finally being looked at a bit more closely again (but not by the FDA yet). See the TIME story or an article in the New England Journal of Medicine for more information.
November 6, 2014
A couple months ago there were a few articles that ran about developing a blood test for Major Depressive Disorder ( see: The Chicago Tribune, CBS News, TIME, Medscape, Huffington Post, Newsweek, New York Magazine and HealthDay). This sounds great: it could revolutionize the diagnostic process making more precise distinctions between Depression and other disorders, syndromes and episodes. However I’m just not sold on the technology yet, and one of the reasons is that frankly we just don’t know that much about Depression and other psychiatric disorders (or about the brain for that matter). So we may be able to identify markers in the blood of “something” but we don’t necessarily know what that means and I fear this will give false confidence to those performing and receiving the tests. You see, human behavior is just too complex to distill down lab values (for now, at least). There are many people who receive antidepressant medications who really don’t need them, and there are many others who could benefit from medication or psychotherapy but don’t receive it; ideally such testing could improve much of this, but I worry that when a truly “depressed” person (layman’s use of “depressed,” not clinical/diagnostic) takes a blood test and his lab values are not indicative of Major Depressive Disorder (the clinical diagnosis), he may not be encouraged to seek the psychotherapy that could very well improve his quality of life, help him function at a higher level and engage in healthier behaviors. Blood tests, and all other diagnostic tests for that matter, can be enormously useful when used in the context of clinical judgement, and can be enormously harmful when not.