Hello everyone! I hope all of you had a wonderful weekend. Lets start our long week ahead some interesting articles!
With recent reports of suicide rates being on the rise in the U.S., we’ve been thinking a lot about what we can do to better detect, diagnose, and treat mental health issues in a wider portion of the population. One suggestion that has been emphasized in recent months is ensuring more screening for mental health issues in primary care. The argument tends to rest on the often-cited statistic that 64% of suicide attempts are associated with a healthcare visit within the previous month. This has led many to suggest that primary care providers could be doing more to prevent suicide, and universal screening for risk is thus often suggested.
There are many reasons to think this might be a good idea on an intuitive basis. But when we explore the literature, it quickly becomes clear that the evidence base on this practice is shaky at best. This led us to wonder about another screening practice at the intersection of primary care and psychiatry: universal screening for depression. How important is universal screening for depression in primary care? What are the benefits and limitations and what do we still need to find out?
Fears over the impact on mental health of smartphones, social media and other trappings of the digital world are driving tech companies to change, but the evidence remains sketchy.
We can appreciate the natural timelines after sudden unexpected death. The first days an unbearable explosion of confused pain that engulfs family and friends. Then funeral preparation. Days of stunned loss and disbelief, the start of the long process of asking why, mixed with the erosive guilt of finding missed warnings. The distracting logistics of navigating medical examiners, funeral directors, wakes, and burials. The funeral itself, hopefully an overwhelming affirmation of a life stopped, a focus of love and loss.
Then the fall.
We do not often talk about the landscape of grief after the immediate loss. When the crowds disperse, the world starts turning again, and those most distressed are left behind. When the questions remain, when the enormity of loss grows with each day of absence. The realization that life has changed forever. When the air is sucked out of bubbles of normality by moments of sharp memory.
THE PATIENT, A man in his early 20s, was clearly distressed, anxious. There were insects, he said, insects crawling around under his skin.
The graduate student doing the initial assessment was immediately concerned and went straight to her advisor, Dr. Brian Sharpless, a clinical psychologist and professor at Argosy University in Virginia. The patient sounded psychotic — possibly schizophrenic, she said, and she wanted to know what to do.
“Is he by any chance Nigerian?” Sharpless asked. “Yes!” she replied. “How did you know?” “He’s not psychotic — that’s Ode Ori,” Sharpless responded. “He’s having a panic attack.”
Ode Ori is, in Nigerian Yoruba culture, the manifestation of acute distress. It’s a crawling sensation in the head and under the skin, noises in the ears, heart palpitations, both an expression of and accompaniment to anxiety. And anxiety calls for a very different treatment protocol than schizophrenia. It was lucky, then, that Sharpless had just recently learned about Ode Ori.
This Special Report offers insight into gender vulnerabilities and clinical implications in areas like schizophrenia, Alzheimer dementia, and anxiety disorders.
Thank you and see you tomorrow for more articles.