psychiatry

From “Eminence-based” to Evidence-based mental healthcare: Time to focus on quality and accountability

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For the men­tal health cri­sis of care, qual­i­ty is as much of a prob­lem as quantity.

Most peo­ple who seek men­tal health care for the first time are baf­fled by how to find a clin­i­cian. I know what many par­ents felt. When my daugh­ter, Lara, fin­ished her first semes­ter at Ober­lin, she returned home to Atlanta thin and exhaust­ed. I was excit­ed to have her back home and entire­ly clue­less about her des­per­ate strug­gle with anorex­ia. In fact, as I learned lat­er, she had been dri­ven by obses­sions about her weight and her appear­ance for over a year by that point. As was true of Amy, her per­fec­tion­ism and her shame at not being per­fect kept her from shar­ing this strug­gle. And now, in a cri­sis after a year of anguish, she was ask­ing for help. As a pro­fes­sor of psy­chi­a­try at the uni­ver­si­ty, I should have noticed her seri­ous men­tal ill­ness, and yet I missed it. At least, now that Lara was ask­ing for help, I should know where to find the best care. But the uni­ver­si­ty had no resources specif­i­cal­ly for eat­ing dis­or­ders, and I could not find a cen­ter for her treat­ment any bet­ter than Amy’s par­ents had. For­tu­nate­ly, Lara, ever the prob­lem solver, found an inten­sive out­pa­tient pro­gram with a superb ther­a­pist and began a long, suc­cess­ful road to recov­ery. But even as a pro­fes­sion­al in this space, I found it dif­fi­cult to nav­i­gate the maze of care. The first issue is that there are so many dif­fer­ent types of pro­fes­sion­als: social work­ers, mar­riage and fam­i­ly coun­selors, clin­i­cal psy­chol­o­gists, pro­fes­sion­al psy­chol­o­gists, psy­chi­a­trists —and they all call them­selves ther­a­pists. The choice real­ly mat­ters, because what you receive depends large­ly on whom you see.

This is not true for can­cer or asth­ma or heart dis­ease, but in men­tal health care, there is lit­tle con­sen­sus among the var­i­ous care providers as to how to approach even the most com­mon forms of men­tal ill­ness. [Read more…] about From “Emi­nence-based” to Evi­dence-based men­tal health­care: Time to focus on qual­i­ty and accountability

Study: Personalized, closed-loop neuromodulation can (one day) become a “pacemaker for the brain”

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Click image above to watch 2‑minute video explain­ing the study

Treat­ing Severe Depres­sion with On-Demand Brain Stim­u­la­tion (UCSF press release):

UCSF Health physi­cians have suc­cess­ful­ly treat­ed a patient with severe depres­sion by tap­ping into the spe­cif­ic brain cir­cuit involved in depres­sive brain pat­terns and reset­ting them using the equiv­a­lent of a pace­mak­er for the brain.

“This study points the way to a new par­a­digm that is des­per­ate­ly need­ed in psy­chi­a­try,” said Andrew Krys­tal, PhD, pro­fes­sor of psy­chi­a­try and mem­ber of the UCSF Weill Insti­tute for Neu­ro­sciences. “We’ve devel­oped a pre­ci­sion-med­i­cine approach that has suc­cess­ful­ly man­aged our patient’s treat­ment-resis­tant depres­sion by iden­ti­fy­ing and mod­u­lat­ing the cir­cuit in her brain that’s unique­ly asso­ci­at­ed with her symp­toms.” [Read more…] about Study: Per­son­al­ized, closed-loop neu­ro­mod­u­la­tion can (one day) become a “pace­mak­er for the brain”

On cognitive reframing and biases, stress, mental health tech, Aduhelm backlash, Britney Spears, and more

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Wel­come to a new edi­tion of Sharp­Brains’ e‑newsletter, fea­tur­ing this time nine sci­en­tif­ic reports and indus­try devel­op­ments to help pro­mote life­long brain and men­tal health.

#1. To low­er stress lev­els and improve prob­lem-solv­ing, prac­tice cog­ni­tive refram­ing instead of venting

“… vent­ing like­ly doesn’t soothe anger as much as aug­ment it. That’s because encour­ag­ing peo­ple to act out their anger makes them relive it in their bod­ies, strength­en­ing the neur­al path­ways for anger and mak­ing it eas­i­er to get angry the next time around. Stud­ies on vent­ing anger (with­out effec­tive feed­back), whether online or ver­bal­ly, have also found it to be gen­er­al­ly unhelp­ful … To get out of that, you can ask the per­son to step back and help you reframe your expe­ri­ence by ask­ing, “How should I think about this dif­fer­ent­ly?” or “What should I do in this situation?”

#2. Head­space and Gin­ger merge to expand and scale up dig­i­tal men­tal health

“The new com­pa­ny would find it push­ing well beyond its cur­rent mind­ful­ness focus to, “pro­vide the full spec­trum of proven, effec­tive vir­tu­al sup­port – from mind­ful­ness and med­i­ta­tion, to text-based behav­ioral health coach­ing, to video-based ther­a­py and psy­chi­a­try – for all types of patient populations.”

Ambi­tious move!

#3. How to read, under­stand and write great med­ical research

12 good tips for stu­dents and every­one else

#4. Vet­er­ans Affairs won’t cov­er Biogen’s new “Alzheimer’s drug” giv­en con­cerns over safe­ty and lack of evidence

Their inde­pen­dent review con­cludes that “giv­en the lack of evi­dence of a robust and mean­ing­ful clin­i­cal ben­e­fit and the known safe­ty sig­nal, we rec­om­mend against offer­ing this agent to patients with Alzheimer’s demen­tia (mild or oth­er­wise) or mild cog­ni­tive impairment.”

#5. Alzheimer’s & Demen­tia researchers chal­lenge FDA’s approval of Aduhelm giv­en lack of evi­dence for beta-amy­loid as a marker

A strong call to “learn how this reg­u­la­to­ry fail­ure occurred and to ensure that it doesn’t occur again”

#6. Debunk­ing four myths about deci­sion-mak­ing capac­i­ty to keep Brit­ney Spears and oth­ers safe

Address­ing the ongo­ing con­tro­ver­sy about con­ser­va­tor­ships, a USC Pro­fes­sor of Law, Psy­chol­o­gy, and Psy­chi­a­try shares a great arti­cle to debunk these all-too-com­mon myths

#7. Study exam­ines com­mon cog­ni­tive bias­es (have you tried this brain teas­er?) and ways to mit­i­gate them

If you have not encoun­tered the “Lin­da brain teas­er” before, please give it a try! If you have, you’ll enjoy the new paper titled Tver­sky and Kahneman’s Cog­ni­tive Illu­sions: Who Can Solve Them, and Why?

#8. Inte­grat­ing music, move­ment and stroke reha­bil­i­ta­tion, MedRhythms rais­es $25M to devel­op and com­mer­cial­ize dig­i­tal therapeutic

Fas­ci­nat­ing approach to gait training.

#9. Neu­rotech start-up Paradromics rais­es $20M to address brain-relat­ed dis­or­ders via next-gen brain-com­put­er interfaces

Neu­ralink vs. Paradromics vs. non-inva­sive plat­forms — quite a stim­u­lat­ing space to track

 

Wish­ing you and yours a hap­py and healthy back-to-school and month of September,

The Sharp­Brains Team

Headspace and Ginger merge to expand and scale up digital mental health

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Head­space and Gin­ger are merg­ing to form Head­space Health (TechCrunch):

Med­i­ta­tion app Head­space this morn­ing announced plans to merge with on-demand men­tal health ser­vice Gin­ger. Bar­ring unfore­seen reg­u­la­to­ry road­blocks, the two com­pa­nies will com­bine to form Head­space Health. The new orga­ni­za­tion would sport a com­bined val­ue of $3 bil­lion and a head­count of more than 800.

The merg­er comes dur­ing accel­er­at­ed usage of both par­ties, as a seem­ing­ly end­less pan­dem­ic has put a strain on men­tal health across the globe and many have turned to vir­tu­al solu­tions to address the grow­ing prob­lem. [Read more…] about Head­space and Gin­ger merge to expand and scale up dig­i­tal men­tal health

On building better brains at any age, treating Depression vs. Dementia, emerging neurotechnologies, psychedelics, and more

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Wel­come to a new edi­tion of Sharp­Brains’ e‑newsletter, fea­tur­ing eleven new research find­ings and inno­v­a­tive resources for life­long cog­ni­tive and brain health.

#1. Debate: Are depres­sion and demen­tia two sides of the same coin? And, if they are, how to best approach treatment?

#2. Either way, the ear­li­er the bet­ter, but it’s nev­er too late: New book out­lines the five lifestyle pil­lars to “build a bet­ter brain at any age”

#3. “If I were a car­di­ol­o­gist eval­u­at­ing a patient’s chest pain, for instance, I would speak with the patient, but then I would lis­ten to their heart and mea­sure their pulse and blood pres­sure. I might order an elec­tro­car­dio­gram or a car­diac stress test, tools that weren’t avail­able a cen­tu­ry ago. Because I’m a psy­chi­a­trist, how­ev­er, I eval­u­ate patients in pre­cise­ly the same way that my pre­de­ces­sors did in 1920…” Read­ing Our Minds: New book issues strong call to action to mod­ern­ize psychiatry

#4. Very time­ly effort by Well­come in the UK: Com­pre­hen­sive research review iden­ti­fies most promis­ing inter­ven­tions to boost work­place men­tal health

#5. “As we enter the sec­ond year of the pan­dem­ic, so many peo­ple are strug­gling and seek­ing men­tal health sup­port. Wysa is an exam­ple of how tech­nol­o­gy is help­ing mil­lions of peo­ple access every­day men­tal health sup­port and self-care tools with­out being gat­ed by a clin­i­cal diag­no­sis.” — Dr. Pankaj Jeth­wani, Exec­u­tive Vice Pres­i­dent at W Health Ven­tures. Arti­fi­cial Intel­li­gence (AI)-enabled chat­bot Wysa rais­es $5.5M to broad­en access to men­tal health support

#6. Study: Social media and gen­er­al tech engage­ment not found to “fry” teenagers’ brains

#7. Akili Inter­ac­tive Labs rais­es $160M in equi­ty and debt to trans­form cog­ni­tive health­care via pre­scrip­tion videogame treat­ments. A nice way to cel­e­brate Akil­i’s 10th anniver­sary … they are tar­get­ing ADHD first (now kids, lat­er teens and adults), to be fol­lowed by treat­ments for a range of cog­ni­tive dis­or­ders relat­ed to depres­sion, Mul­ti­ple Scle­ro­sis, Autism, “Covid-Fog” and more.

#8. Study: High­er men­tal well­be­ing (in 2016) seen to low­er health­care costs (in 2017). We still have time to invest in pub­lic men­tal well­be­ing in 2021.

#9. Teladoc Health, hav­ing acquired Livon­go and myS­trength, launch­es inte­grat­ed men­tal health ser­vice for the work­place. “The announce­ment comes as more than half of peo­ple with men­tal health con­cerns report that they do not know where to start when get­ting care, high­light­ing the impor­tance of the dig­i­tal front door myS­trength Com­plete will pro­vide…” This is indeed a very com­mon pain point accord­ing to our own research, so good to see the quite com­pre­hen­sive & per­son­al­ized approach.

#10. Cumu­lus Neu­ro­science rais­es $8.3M to devel­op EEG-based wire­less ‘Fit­bit for the brain’ — Fas­ci­nat­ing to see the major role of the Demen­tia Dis­cov­ery Fund, in a bid to accel­er­ate clin­i­cal tri­als and poten­tial therapies.

#11. Last but not least, a very promis­ing clin­i­cal appli­ca­tion of psy­che­delics: Study finds MDMA-assist­ed ther­a­py to be safe and high­ly effec­tive to treat severe PTSD. “The Nature authors spec­u­late that MDMA-assist­ed ses­sions pro­duce a “win­dow of tol­er­ance,” in which patients are able to revis­it trau­mat­ic mem­o­ries, with less shame and anger, and with­out being over­whelmed by PTSD symptoms.”

Wish­ing you a healthy Memo­r­i­al Week­end and month of June,

The Sharp­Brains Team

Reading Our Minds: New book issues strong call to action to modernize psychiatry

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The Rise of Big Data Psy­chi­a­try (The Wall Street Journal):

As a physi­cian, I need to fig­ure out three things when a new patient walks into my office: what their life is typ­i­cal­ly like, what has changed that made them seek treat­ment and what I can do to help them. It’s a com­plex prob­lem, and most fields of med­i­cine approach it by tak­ing mea­sure­ments. If I were a car­di­ol­o­gist eval­u­at­ing a patient’s chest pain, for instance, I would speak with the patient, but then I would lis­ten to their heart and mea­sure their pulse and blood pres­sure. I might order an elec­tro­car­dio­gram or a car­diac stress test, tools that weren’t avail­able a cen­tu­ry ago.

Because I’m a psy­chi­a­trist, how­ev­er, I eval­u­ate patients in pre­cise­ly the same way that my pre­de­ces­sors did in 1920: I ask them to tell me what’s wrong, and while they’re talk­ing I care­ful­ly observe their speech and behav­ior. But psy­chi­a­try has remained large­ly immune to mea­sure­ment. At no point in the exam­i­na­tion do I gath­er numer­i­cal data about the patient’s life or behav­ior, even though tools for tak­ing such mea­sure­ments already exist. In fact, you like­ly are car­ry­ing one around in your pock­et right now. Keep read­ing essay HERE, adapt­ed from the new book Read­ing Our Minds: The Rise of Big Data Psy­chi­a­try by psy­chi­a­trist Daniel Bar­ron. [Read more…] about Read­ing Our Minds: New book issues strong call to action to mod­ern­ize psychiatry