Psychiatric Services, a leading US journal, has published two important papers on Open Dialogue. Freeman and colleagues did an extensive literature review and analysis of currently available research. Their paper is accompanied by a commentary by Kim Mueser, PhD, Director of the Boston University Center for Psychiatric Rehabilitation and one of the world’s experts in his field.
Freeman and colleagues begin their paper with a detailed explanation of the criteria for inclusion into their investigation. They identified 23 studies for review. Papers selected were published in English and evaluated Open Dialogue effectiveness using either case study, qualitative, quantitative, or mixed methods. Studies were conducted in Finland, Norway, Sweden, and the US.
As the authors point out, most of the available research comes from the Western Lapland group that developed Open Dialogue (OD). This poses a fundamental source of weakness in the evidence base. Their studies had small sample sizes, there was no control group, and the ratings were not blinded. In addition, there were not consistent methods for either defining or evaluating OD.
Many of us learned of Open Dialogue because of their reported excellent outcomes for individuals who experienced a first episode of psychosis. We are eager to see if these results can be replicated elsewhere. But there are other important questions.Read More
The Fort Collins-based Learning and Self-development Collaborative grant project is midway through supporting its first group of young adults experiencing mood-related distress. It is also actively recruiting for the second group, scheduled to start in late August.
Nearly three-quarters of the young adults in the first group have prior mood disorder diagnoses and have tried psychiatric medications like antidepressants. However, the ineffectiveness and intolerable side effects of the drugs had left them searching for an alternative way forward when they decided to enroll in the Learning and Self-development Collaborative. These young adults are currently medication-free and their outcomes on mood distress, social connectedness, empowerment, and quality of life at six months will be compared to other young adults receiving usual care and daily psychiatric medications in the community.
An initial focus group with participants revealed a number of themes related to young adults’ past experiences with seeking help. Participants discussed feeling frustrated by one-size-fits-all solutions, such as drugs and mindfulness techniques, and invalidated by counselors who failed to connect with their experiences. Lack of information about prescribed drugs was frequently brought up by participants who also shared various stories of “chemical imbalance” and drugs “re-training the brain to relax” told to them by doctors and therapists.
Findings from pre-program focus groups are being used to help inform the content and delivery of educational material in the Learning and Self-development Collaborative.Read More
The generosity of people donating to these two charitable funds is heartwarming. Both funds were established to support research in the area of nutrition and mental health, and we are beginning to do just that.
I’m so pleased to announce the following:Read More
Sir Robin Murray, a distinguished British professor of psychiatry, recently published a paper in Schizophrenia Bulletin titled, “Mistakes I Have Made in My Research Career.” He describes the evolution of his thinking regarding the concept of schizophrenia, including the problems with the neurodevelopmental model, the limitations of the drugs used to treat the condition, and his failure to pay adequate attention to the role of social factors in the etiology of psychotic states. These ideas are not new to anyone who has read Anatomy of an Epidemic. Sir Robin’s ’s paper could be read as a synopsis of Chapter 6, “A Paradox Revealed.”Read More
Several years ago, a person whom I was serving as a psychiatrist changed my life. This man had been a participant for some years in the services of the non-profit where I work, Advocates in Framingham, Massachusetts.
He had spent years going in and out of hospitals, for what doctors called bipolar disorder, but what he himself experienced as periods of great spiritual elation (which clinically looked like mania) alternating with what he described as “spiritual hibernation” (which looked like severe depression).Read More
The New Zealand government is currently writing a new law (Natural Health Products Bill) aimed to regulate natural health products (NHPs). What is happening in New Zealand is not unique: the push for tighter controls on NHPs is occurring all over the world, including Europe, Canada and South Africa. However, if it wasn’t evident before, these newer regulations make it crystal clear that prescription drugs have a monopoly over the terms “medicine” and “therapeutic benefit,” and that it is very difficult for anything that isn’t a Big Pharma drug to make a therapeutic claim. It is the regulations of medicines, not the regulations of NHPs, that result in vague labels on products. Let us explain, using New Zealand’s current proposed bill as an example.Read More
Many of you know the story of how EMPowerPlus was formulated, and that David Hardy’s 20 years of knowledge gained from studying nutrition in farm animals guided the broad-spectrum micronutrient formula that became the focus of the company (Truehope) that he and Tony Stephan established together. Recently, David split off from Truehope (which is still run very capably by Tony Stephan and his colleagues, partnered with Q Sciences) to form Hardy Nutritionals, which produces its own broad-spectrum formula called Daily Essential Nutrients (DEN). So David’s expertise contributed to the formation of both companies, which have served as the bedrock of this entirely new line of research called Nutritional Psychology or Psychiatry.
Sadly, I am writing today to let you know that David had a serious stroke last week. The neurosurgeons were unable to control his brain swelling, and he died in Calgary, at the Foothills Medical Centre, on Sunday November 13 at the age of 66.Read More
The new donation was given to further stimulate investment in this area of research thus far neglected by government funding agencies — the use of broad-spectrum micronutrients for the treatment of mental health symptoms.
Thanks to the commitment of another anonymous donor, the Nutrition and Mental Health Research Fund at the Foundation for Excellence in Mental Health Care now has an additional $100,000 to further our knowledge of how nutrition influences mental health and also to support and cultivate young scientists working on this important topic.
The Nutrition and Mental Health Research Fund was established by Dr. Bonnie Kaplan, PhD in 2015 to support research and education on the ability of broad-spectrum nutrient treatments to reverse and prevent the onset of psychiatric symptoms, an area that has not yet been considered a priority by public funding agencies.Read More
The Collaborative Pathway is a replication and adaptation of Open Dialogue at Advocates, Inc., the human services agency in Framingham, Massachusetts, where I serve as Medical Director. Last week, our team (Chris Gordon, Vasudha Gidugu, Sally Rogers, John DeRonck, and Doug Ziedonis) published an article in the Best Practices column of the journal Psychiatric Services, describing the program and our results from the first cohort of young people and families experiencing a psychotic crisis.
This is the first published adaptation of Open Dialogue in the U.S. and represents the culmination of several years of planning, training and direct service. None of it would have been possible without generous initial funding from the Foundation for Excellence in Mental Health Care.
We provided our services to 16 young people and families over a period of one year. Most have continued to receive services after the study period, so we have more substantial follow-up data than was published in this initial paper. It’s hard to draw many conclusions about Open Dialogue from such a small sample, but I would like to share some of the promising lessons we’ve learned along the way:Read More
Antipsychotics: Short and Long-term Effects (3.5CME/2.5CEU) | Dr. Sandra Steingard, MD
Psychiatric Medications and Long-term Outcomes for Schizophrenia (3.0 CME/2.5CEU) | Dr. Martin Harrow, PhD
Saks Institute Symposium, Los Angeles, CA, March 30, 2015
At University of Southern California’s Town & Gown Ballroom. It will be a one-day symposium focusing on best practices for meeting the mental health needs of university and community college students with special attention to the needs of student military veterans.
The symposium will review new data generated over the last decade related to the treatment, course, and outcome of serious mental illnesses and discuss the implications of these data for changing clinical practice in psychiatry. Among the speakers will be Martin Harrow, PhD (University of Illinois) and Lex Wunderink, MD, PhD (University of Groningen, The Netherlands). It is co-sponsored by Yale Program for Recovery and Community Health, the Foundation for Excellence in Mental Health Care and the Connecticut Department of Mental Health and Addiction Services. More | Symposium Schedule | Register NowRead More