Tuesday, November 24, 2009

Winter Blues book review

Winter Blues (Revised 2006) by Norman Rosenthal, MD is THE classic book on Seasonal Affective Disorder (SAD). Rosenthal started his psychiatric career as a research fellow at the National Institute of Mental Health (NIMH) and was one of the original researchers. In this addition, he also references his own experiences with SAD and what has been helpful to himself.

While the main thrust is on Light Therapy (LT), he also gives full and balanced discussion to other researched interventions, i.e., medications, psychotherapy (especially Cognitive Behavioral Therapy – CBT), negative ions, exercise, vitamins, etc. I appreciate that Dr. Rosenthal is not afraid to give his own opinions to questions about LT, after giving what is known through research.

Overall, it is important to know that SAD is very treatable for most people, whether with LT and/or with other interventions.

Winter Blues is well written and practical, doing an excellent job in referencing scientific studies in understandable language. Recommended for anyone with concerns about possible SAD issues.

Wednesday, November 18, 2009

Reducing further suicide attempts

Suicide is the fourth leading cause of death for those under 65! A study in Philadelphia showed that recent suicide attempters treated with cognitive therapy (CT) were 50 percent less likely to try to kill themselves again within 18 months than those who did not receive the therapy. People were recruited for this study in the emergency room, following a suicide attempt. One hundred and twenty people were either assigned to CT or usual community treatment.

Seventy-seven percent had major depression and 68% a substance use disorder. About half of the participants in both groups took psychotropic medications and about 13% to 16% received drug abuse treatment. About 27% of those in the usual care group received psychotherapy outside of the study, compared to 21% of those also receiving cognitive therapy.

Over the year-and-a-half follow-up period, only 24% (13) of those in the cognitive therapy group made repeat suicide attempts, compared to 42% (23) of the usual care group. Although the groups did not differ significantly in suicidal thoughts, those who received cognitive therapy scored better on measures of depression severity and hopelessness, which the researchers suggest "may be more highly associated with a reduced risk of repeat suicide attempts."

One of the researchers reported, "We were surprised by the amount of energy and resources it takes to reach out to individuals who attempt suicide. This population lacks a positive attitude toward the mental health system and often fails to show up for scheduled appointments. However, the combination of cognitive therapy plus case management services was effective in preventing suicide attempts." He suggests that cognitive therapy's short-term nature makes it a good fit for treatment of suicide attempters at community mental health centers.

If you know someone that has made a suicide attempt, some psychotherapy follow-up should be mandatory.

Best wishes,


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