Thursday, May 24, 2012
There is reason to hope that mental health might be improving. Most of the common mental illnesses are treatable and diminishing stigma and acceptance of these issues means that more people are seeking treatment. Ideally, this would result in declining prevalence. In Canada, we have some interesting sources of data to examine these questions since several national surveys that have collected data using the same questions since 1994, right up to the current time. Looking at these measures, we were recently disappointed to see that mental health in the population was not improving, at least not when measured using items that rate symptoms. However, there are more people that report being diagnosed with a mood disorder and treatment with antidepressants has continued to increase. An interesting result is that a diminishing proportion of Canadians report that their lives are extremely stressful - this probably means that they are becoming more likely to interpret stress-related symptoms such as depression and anxiety as symptoms of an illness rather than just reactions to life problems. This probably reflects increasing mental health literacy in the population. An abstract for this paper may be found here.
Tuesday, May 8, 2012
A recent narrative review article, that seems to have attracted a lot of media attention, has recently made the claim that antidepressants may do more harm than good. While dialogue about the safety and value of medications is good, it is important to remember that this kind of review is not to be confused with an actual weighing of risks and benefits. Appropriate methods exist for the latter - and these methods were not adopted by these authors. Not all bloggers have fully appreciated this, and at least one blog referred to this paper as a meta-analysis (the authors merely refer to a meta-analysis of animal studies as well as several other previously published human meta-analyses in the review). A critique of the review has been offered by Sareen and Enns.
Saturday, May 5, 2012
Something that has been missing from the Canadian landscape has been a national plan for mental health. This partially results from constitutional issues that make health care a provincial responsibility. The Mental Health Commission of Canada will be addressing this deficit next week with its release of a national mental health strategy on Wed May 8th!