The first articles by Iain Chalmers announcing the Cochrane Collaboration appeared in 1992 (1), whose mission would be to systematically review medical evidence with a view to producing the best quality and trustworthy evidence (2). Writing The Antidepressant Era in 1995, I characterised systematic reviews as a logical, and necessary medical development (3). Although the founders came from Canada (Sackett and Enkin), the United States (Dickersin), Denmark (Gøtzsche) and elsewhere, from the mid-1990s, the United Kingdom (UK) became the home of the Collaboration.
The idea of embodying Evidence Based Medicine (EBM) in Guidelines also took shape at this time. In Britain, in 1997, a Labour government created a National Institute for Clinical Excellence (NICE) which began issuing Guidelines underpinned by Cochrane methods and in some instances with Cochrane collaboration. The NICE process was and still is highly regarded, sufficiently so for the Labour government to issue a new plan for Britain’s National Health Service (NHS) that on the basis of newly-minted standards of care set about standardising the health service in a manner that embraces continuity of data, with an interchangeability of personnel, rather than continuity of care (4).Read More
(Wilsonville, OR) – Ronda “Ro” Speight, New York Certified Peer Specialist, is committed to pioneering the advancement of Professional Peer Support in the mental health field. Specifically, helping to define what are “collaborative practices” between peer professionals and traditional mental health professions. Ro has been trained in various peer professional and progressive clinical methodologies, which benefit from integrating the peer professional perspective.
In the interest of this commitment, she has been trained in Social Networking, derived from Open Dialogue, currently aiming to utilize the strengths of both clinical and peer facilitation in the United States. Ro is trained as a Hearing Voices Network Facilitator, which is transforming traditional stigmas and perspectives of voice hearing and other alternative sensory phenomena. She is currently working as a Peer and Recovery Specialist at Mental Health Association (MHA) of Westchester, New York. MHA programs include On Track New York, a comprehensive program for young individuals experiencing first-episode psychosis and the Westchester Recovery Network, a peer-directed in-community peer support program.
Ro is also active in the larger New York community, modeling and applying peer professional competencies in traditional medical model settings. She is currently supporting the peer professional presence at New York Presbyterian Hospital- Westchester Division, developing comprehensive Peer Professional led wellness groups on inpatient units. Ro is enjoying being an agent of positive change after years of trying to personally navigate her identity and purpose through a complicated mental health system.
Laysha Ostrow is the founder and CEO of Live & Learn, Inc., a California-based, consumer-run and woman-owned social enterprise that provides research, technical assistance, and knowledge translation services to behavioral health system stakeholders. She is also an Adjunct Professor in the School of Community and Global Health at Claremont Graduate University and holds a PhD from the Johns Hopkins School of Public Health and a Master of Public Policy from the Heller School for Social Policy and Management at Brandeis University. Laysha completed a Postdoctoral Research Fellowship in the Department of Psychiatry at UCSF and maintains a position there as a Visiting Professional.
She has been an invited speaker at the Carter Center Symposium, the Kennedy Forum on Mental Health, the U.S. Senate HELP Committee’s roundtable to reauthorize the Higher Education Act, and the California Health Facilities Financing Authority. In 2016, Laysha was the recipient of the 2016 Carol T. Mowbray Early Career Research Award from the Psychiatric Rehabilitation Association.
As a person who experienced mental health systems that are often ineffective at promoting recovery and community inclusion, she is passionate about improving these systems through research that advances the use of evidence-based practices in real-world settings.
(MadInAmerica.com) – From The British Psychological Society: “C.O.P.E. [Campaign against the Over-prescription of Psychiatric drugs in Education] is a group of child mental health professionals…[whose] primary aim is to change public policy in key areas of child and adolescent mental health…an attempt to initiate this change was made as part of the consultation process for the new NICE [National Institute for Health and Care Excellence] Guidelines.
The BPS requested that NICE should consider recommending a ban on medicating children with psycho-stimulants who are under the age of five years old…Our C.O.P.E. mission statement clearly articulates our collective beliefs well and includes this area of policy:
We share the view that a caring and morally mindful society must better safeguard children by allowing them to develop their unique personalities and behaviours without a first response to prescribe psychiatric drugs for their behavioural difficulties.
We especially believe that children under the age of five should not be prescribed psychiatric drugs if their behaviour is the only concern.
Please help us to better safeguard children, which is our shared primary duty, and challenge the inappropriate use of psychiatric drugs in the young by signing the petition and supporting our objectives through professional discussions in mental health teams and childrens’ services.”Read More
(Medscape) – Young patients with recent-onset schizophrenia do not show signs of cognitive deterioration or disruption of ongoing brain development in the first years following illness onset, new research shows.
Results of a large longitudinal study show that young patients with schizophrenia experience cognitive impairment prior to the onset of psychotic symptoms, but the trajectory of their neurobehavioral development and performance is comparable to that of healthy control persons.
“The study results suggest that whatever effect cognition has in schizophrenia seems to happen before people develop clinical symptoms, the psychotic symptoms,” study investigator Cameron S. Carter, MD, professor of psychiatry and psychology, and director of the Schizophrenia Research and Education Program, Department of Psychiatry and Behavioural Sciences, University of California, Davis, told Medscape Medical News.
“So cognitive dysfunction is already there when people come in for treatment,” he said.
The findings are in line with the neurodevelopmental model of schizophrenia. This model hypothesizes that prenatal central nervous system insultsand/or genetic alterations during early brain developmentinteract with environmental risk factors and lead to the onset of psychosis in late adolescence or early adulthood.
“The study confirms our sense that schizophrenia is not a neurodegenerative disorder; the brain does not necessarily deteriorate after people become ill and develop these symptoms,” said Carter.
“In fact, these young people have the capacity to continue to improve and develop to the same degree as typical individuals,” he said.
The study was published online October 3 in JAMA Psychiatry.Read More
Going to the ‘Dark Side’
(Medscape) – A few years ago, while attending a research conference, I inquired with a friend, a prominent professor from Sweden, about our mutual colleague, a young, bright psychiatrist with a great research career ahead of him. “He’s gone to the Dark Side!” was his reply.
I had not heard this term before in this setting. Images flew across my mind. Did the young man have a psychotic break? Did he get sick? Was he in jail?
Confused, I asked my friend what he meant. Laughing, he clarified, “He went to work for the pharmaceutical industry!”
Oh, that Dark Side.
It’s a term that I continued to hear when, a few years ago, I myself took a position in the pharmaceutical industry. It appears that those of us in the industry had taken the description so to heart, however jokingly, that we felt comfortable applying it amongst ourselves.
“Welcome to the Dark Side,” a colleague in industry emailed me when I told him about my new job at a biomedical research group in the United States that conducts early drug discovery work. Even my coworkers within this group would refer jokingly to our colleagues in the company’s European headquarters (where they conduct the large phase 3 trials) as the Dark Side, who in turn would use the term to refer to the commercial marketing team.
The prevalence of this term represents an easy dichotomy, pitting the Machiavellian scheming of industry against the unsullied Ivory Towers of academia. However, after 25 years and a solid career in academia, I came to see it as its own sort of Dark Side, where the drive for self-preservation outweighed actual progress.Read More
NEW YORK (Reuters Health) – Comorbid symptoms of anxiety and depression are worse in patients with irritable bowel syndrome (IBS) compared to those with inflammatory bowel disease (IBD), a new meta-analysis shows.
“Although the prevalence of depression was similar between IBS and IBD patients, the study found that depression and anxiety was more severe in IBS patients compared to IBD patients,” Dr. Qin Geng of China-Japan Friendship Hospital in Beijing and his colleagues note in the Journal of Affective Disorders, online May 4.Read More
Our last blog reported on a study that found that a combination of micronutrients was effective in reducing aggression in children struggling with behavioural problems. Given that this finding replicated several previous studies over the last two decades, we wondered why the cumulative results weren’t impacting clinical practice.
Julia’s lab just published still another study in the Journal of Child Psychology and Psychiatry confirming the importance of nutrients in reducing aggression, this time in children presenting with ADHD.
So what did this latest study find?Read More
(Wilsonville, OR) – MindFreedom International, headquartered in Eugene, Oregon, will create web-based resources designed to empower, inspire and give individuals with lived experience of mental health challenges the skills they need to be effective leaders in the community. This online resource will draw on the collective wisdom of its members and affiliates, most of whom identify as psychiatric survivors, and include two webinar trainings, a series of videos and a pocket handbook.Read More
(Wilsonville, OR) – Award-winning director/producer Lucy Winer has teamed up with author and Distinguished Professor of History Nancy Tomes at Stony Brook University to create an innovative digital learning site for health care students and professionals. The site will consist of an extensive video archive and online curriculum that aims to build awareness of the past and instill attitudes and values essential to a mental health care system grounded in the principles of recovery.
“This project is important because it will allow residents the opportunity to look at and discuss issues that are often not included in psychiatric training. These profound glimpses into the past highlight how our mental health care system has evolved and underscore the importance of building a future where patient-centered and recovery-oriented care is central to the work we do as mental health providers,” said Melissa Arbuckle, MD, PhD, Vice Chair for Education and Director of Resident Education in the Department of Psychiatry, Columbia University.Read More
(Wilsonville, OR) – Principal investigator Lisa Dixon, MD, MPH, Professor of Psychiatry at Columbia University Medical Center and Director of the Division of Behavioral Health Services & Policy Research and the Center for Practice Innovations at the New York State Psychiatric Institute will head up a new project to test enhancing one site of the OnTrackNY program with family engagement and support services which draw on the Needs Adapted and Open Dialogue models with the goal of improving treatment and recovery outcomes.
OnTrackNY was developed to treat young adults within two years of experiencing an episode of psychosis. The project is a collaboration with OnTrackNY at The Mental Health Association of Westchester and will be the latest adaptation of the Finnish Open Dialogue model to be tested in the United States. It will offer a family therapy option that brings together the person at the center of concern and members of their social network to navigate crises and assist in treatment planning.Read More