Editor in Chief
It’s that time of year again. We polled our editorial board and our newly constituted advisory board of early career psychiatrists. This year we asked about the best and worst things relating to our field. As always, we received a diverse group of responses. While there were no transformational advances, I’m sure you’ll agree there is progress in many areas and a variety of topics that provide food for thought. Although the comments are excellent, space limitations prevent us from publishing all that we received.
Dr. Brian Miller selected the FDA approval of valbenazine as the most important event/development in psychiatry in 2017.1 Valbenazine is the first FDA-approved drug for the treatment of tardive dyskinesia. Several others, including Dr. Renato Alarcón, suggested the increasing study of formerly banned substances such as ketamine and psilocybin as important avenues for future medication development.
My choice for one of the most important advances this year involves the meta-analysis published several months ago in the that compared cognitive behavioral therapy (CBT) with psychodynamic therapy outcomes.2 The article reports that treatment outcomes for depression are similar between CBT and psychodynamic therapies. Given the assertions in recent years by CBT researchers that its effectiveness is the most highly substantiated by research studies, this publication’s conclusions come as welcome news for practitioners of psychodynamic therapies.3
Dr. John Torous told us, “One of the ‘best’ things we are seeing is evidence and research beginning to catch up with digital mental health. While there is still much out there that we do not know, we are now beginning to see real data that are helping us begin to actually evaluate apps on their merits vs marketing claims.”
Along the same line of innovation, Dr. Awais Aftab chooses the FDA announcement that it would permit marketing of the first mobile medical app (the reSET application, Pear Therapeutics) for the treatment of an array of substance use disorders. The app is prescription-only and used as an adjunct to standard outpatient clinical treatment and contingency management. It is approved to treat alcohol, cocaine, marijuana, and stimulant substance use disorders, but not opioid use disorder. Its approval was based on data from a multi-site 12-week clinical trial of almost 400 patients, in which app users showed a significant increase in adherence to abstinence. This is likely a harbinger of the future role of digital innovations and applications in psychiatric care.
Dr. Alarc ón also emphasizes the increasing use of telepsychiatry as a way to reach out to communities deprived of specialized mental health resources.
New research funding
Dr. Peter Buckley highlights this year’s passage of the NIH BRAIN initiative. Not only will this endeavor bring new funding for research to better understand the brain, but it will foster increased interdisciplinary research crucial to important advances.
1. Tasman A. Tardive dyskinesia: finally some good news. Psychiatric Times. May 2017. http://www.psychiatrictimes.com/psychopharmacology/tardive-dyskinesia-finally-some-good-news. Accessed November 17, 2017.
2. Steinert C, Munder T, Rabung S, et al. Psychodynamic therapy” as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. Am J Psychiatry. 2017; 10:943-953.
3. Tasman A. You are always on my mind. Psychiatric Times. November 2017;34:11-12.
4. CRAZYWISE. https://crazywisefilm.com/#home. Accessed November 17, 2017.
5. Laing RD. The Divided Self. New York: Penguin Psychology; 1965.
6. Alarcón RD. Positive psychiatry: an interview with Dilip V. Jeste, MD. Psychiatric Times. February 2016. http://www.psychiatrictimes.com/psychotherapy/positive-psychiatry-interview-dilip-v-jeste-md. Accessed November 17, 2017.
7. Sanacora G, Frye MA, McDonald W, et al, for the American Psychiatric Association (APA) Council of Research Task Force on Novel Biomarkers and Treatments. A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry. 2017;74:399-405.