3 ms·

Designing psychiatric care to precisely match patients’ biology

2 points by chmaynard 5y ago

PaulHoule 5y ago
From the article "During the pandemic, the number of people suffering from depression doubled." I have access to a lot of polling data (the paywalled web site below is one I work on) and what I find remarkable is that I don't see a really strong story in the time series where they poll people about their emotions. "Lonely" has been a little below 25% throughout the pandemic. https://www.healthpolldatabase.org/hpd/trend/00e59c04-80f3-439f-a0de-3a979c3d5667 https://www.healthpolldatabase.org/hpd/trend/00e59c04-80f3-4... "Sad" peaked at 38% on June 1, 2020 and was 23% on April 19, 2021 https://www.healthpolldatabase.org/hpd/trend/f04d9480-cc75-47ec-a9f6-3e0dc9f15318 https://www.healthpolldatabase.org/hpd/trend/f04d9480-cc75-4... Even though I'd expect people to be in a bad mood because of conditions it doesn't seem like they are telling pollsters that.
- rsynnott 5y ago
  I always wonder a bit about this sort of polling. I felt pretty awful for the duration of the pandemic. If someone had phoned me to take a poll, I’d have declined, because I was stressed and miserable and didn’t want to deal with anything more than I had to; I really did nothing other than work and walk aimlessly for a year or so. If I’d somehow had to answer a poll on how I was feeling, I’m not sure that I’d have been honest; when you feel really bad, it’s often not the easiest thing to talk about. I’d be inclined to trust data on diagnoses here more than polling on how people are feeling. Though that’s imperfect, too, of course. But polling on how you’re feeling seems really hard to do properly, because how you’re feeling will feed into whether you consent to be polled and how open you are if you do.
PaulHoule 5y ago
The best practice now is "see your PCP, try some pills for a few weeks, talk to your PCP, change the dose, talk to your PCP, try a different pill". You will wait 2-3 weeks to know you are improving and could spend a few months settling in with a good Rx. That's probably less expensive than a functional MRI but it is slow.
- phren0logy 5y ago
  I'm a psychiatrist. Not only would it be expensive, but the functional MRI (at least right now in 2022) would be highly unlikely to provide useful information about how to manage your depression, or what medication (or psychotherapy) would likely help. Perhaps the one exception is that it could help pick a site for TMS.
  - PaulHoule 5y ago
    The Stanford folks are claiming that the functional MRI would be useful, but I'm inclined to believe that you're right.

2 points by chmaynard 5y ago

From the article "During the pandemic, the number of people suffering from depression doubled." I have access to a lot of polling data (the paywalled web site below is one I work on) and what I find remarkable is that I don't see a really strong story in the time series where they poll people about their emotions. "Lonely" has been a little below 25% throughout the pandemic. https://www.healthpolldatabase.org/hpd/trend/00e59c04-80f3-439f-a0de-3a979c3d5667 https://www.healthpolldatabase.org/hpd/trend/00e59c04-80f3-4... "Sad" peaked at 38% on June 1, 2020 and was 23% on April 19, 2021 https://www.healthpolldatabase.org/hpd/trend/f04d9480-cc75-47ec-a9f6-3e0dc9f15318 https://www.healthpolldatabase.org/hpd/trend/f04d9480-cc75-4... Even though I'd expect people to be in a bad mood because of conditions it doesn't seem like they are telling pollsters that.

rsynnott 5y ago
I always wonder a bit about this sort of polling. I felt pretty awful for the duration of the pandemic. If someone had phoned me to take a poll, I’d have declined, because I was stressed and miserable and didn’t want to deal with anything more than I had to; I really did nothing other than work and walk aimlessly for a year or so. If I’d somehow had to answer a poll on how I was feeling, I’m not sure that I’d have been honest; when you feel really bad, it’s often not the easiest thing to talk about. I’d be inclined to trust data on diagnoses here more than polling on how people are feeling. Though that’s imperfect, too, of course. But polling on how you’re feeling seems really hard to do properly, because how you’re feeling will feed into whether you consent to be polled and how open you are if you do.

PaulHoule 5y ago

The best practice now is "see your PCP, try some pills for a few weeks, talk to your PCP, change the dose, talk to your PCP, try a different pill". You will wait 2-3 weeks to know you are improving and could spend a few months settling in with a good Rx. That's probably less expensive than a functional MRI but it is slow.

phren0logy 5y ago
I'm a psychiatrist. Not only would it be expensive, but the functional MRI (at least right now in 2022) would be highly unlikely to provide useful information about how to manage your depression, or what medication (or psychotherapy) would likely help. Perhaps the one exception is that it could help pick a site for TMS.
- PaulHoule 5y ago
  The Stanford folks are claiming that the functional MRI would be useful, but I'm inclined to believe that you're right.