Post Of The Week -Saturday 30th April 2016

1) Willem Kuyken on Mindfulness Based CBT

A study has come out this week which shows that MCBT is effective in preventing relapse in people suffering multiple episodes of depression. You can read about that here.

Mindfulness-based cognitive therapy can prevent recurrent depression

Kuyken gives an extended interview about this study and other issues connected with MCBT here.

He says some important things along the way: the difficulty of setting up RCTs and their limitations, quality of therapy, working out which treatment works best in the cycle of illness and recovery, researcher bias, developing mindfulness based practices in schools to address problems of student mental health. Great stuff.

 

2) Nicotine Without Smoke

In A2 over the last couple of weeks, we have been looking at biological interventions for smoking addiction. One of the key arguments in favour of drug treatment over Nicotine Replacement Therapies is that NRT involves putting a substance into people’s bodies which is known to be harmful.

https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0

This report from the Royal College Of Physicians promotes the use of e-cigarettes and NRT as a means of helping people give up smoking. Given some recent evidence which suggests that, when people with other mental health issues are removed from the analysis, NRT is not inferior to drug treatments, this recommendation looks significant. The report also mentions that such interventions without psychological support are unlikely to work.

On the other hand, this piece of research makes the case for drug treatments, including in terms of appropriateness: there is no evidence of adverse neuropsychiatric events.

https://www.sciencedaily.com/releases/2016/04/160422201036.htm

 

3) Ketamine Again

This paper suggests that Ketamine is effective in treating treatment-resistant depression.

http://ebmh.bmj.com/content/19/2/35.full

The trouble is that nobody knows the long term consequences of doing this.

 

4) Pim Cuijpers

Here’s the latest from him, comparing different psychological therapies.

http://ebmh.bmj.com/content/19/2/39.full

Cuijpers suggests that we do not have powerful enough studies to be able to say which therapies work better than others. In doing so, he echoes some of the comments of Kuyken above on the limitations of RCTs.

 

5) Neuro-Milgram

A big claim of Milgram is that people enter an agentic state in situations where the power of an authority figure is overwhelming. In effect, they pass over control of their actions to the authority figure.

http://digest.bps.org.uk/2016/04/neuro-milgram-your-brain-takes-less.html

This article explains what this looks like when analysed in a brain scan.

 

6) Family Therapy

Anxious parents tend to produce anxious children.

Stop Children ‘Catching’ Your Anxiety Before It’s Too Late

This article suggests that this can be prevented through a psychological family check up where sources of anxiety are addressed before they become too serious. The results are promising.

 

7) Replication Crisis

The section of this new All In The Mind from about 12 minutes in deals with the replication crisis. It looks in particular at an attempt to reproduce findings about ego depletion.

http://www.bbc.co.uk/programmes/b078774b

Replication is harder than it sounds. David Shanks from UCL has some judicious things to say at the end. Replication is a problem not just in Psychology.

 

8) Integrated Care

We end up in lessons increasingly referring to co-morbidity. People have more than one thing wrong with them. Mental health problems often occur alongside physical health problems.

Bringing together physical and mental health: King’s Fund report on integrated care

This article explains why systems of care which integrate physical and mental health care are needed. That is worth thinking about for those of you who want to be the doctors and health service leaders of the future.

 

 

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