50 years of SSRIs: weighing benefits and harms

“In her book Chemically Imbalanced, Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London, synthesizes three key questions around the use of SSRIs [selective serotonin reuptake inhibitors]. First, on effectiveness, Moncrieff references a 2002 meta-analysis, which concluded that compared with placebo their effects were clinically negligible. However, other studies have shown effectiveness, including a 2018 meta-analysis in The Lancet, which concluded that all antidepressants are more efficacious than placebo in adults with a diagnosis of major depressive disorder, with odds ratios ranging between 2·23 and 1·37. Second, Moncrieff reviews the so-called serotonin hypothesis of depression. In 1975, … Read More

The Paradoxes of Feminine Muscle

In a new book, the author Casey Johnston argues that pumping iron helped her “escape diet culture.” But a preoccupation with strength can take many forms. Excerpt – “Ask a man why he lifts, and that man will lie to your face,” he [Lifter, classical music critic and author of “Swole: The Making of Men and the Meaning of Muscle” Michael Andor Brodeur] writes. “He will assert and insist that his ‘training’ is purely in service of health, fitness, strength, endurance, stamina, and whatever other buzzwords he can throw in to throw you off the trail.” It is somewhat déclassé … Read More

F.D.A. Approves First At-Home Alternative to the Pap Smear

The tool will allow women to screen for HPV, which causes almost all cases of cervical cancer, without visiting a doctor. Excerpt – The Food and Drug Administration approved the United States’ first at-home cervical cancer screening tool on Friday, a decision that stands to give women an accessible alternative to Pap smears, which many find painful or traumatic. The new test, made by Teal Health, involves swabbing the vagina with a spongelike tool rather than inserting a speculum and scraping cells from the cervix, as health care providers do in Pap smears. [..] Cervical cancer experts told The New … Read More

Can Whitney Wolfe Herd Make Us Love Dating Apps Again?

Bumble CEO Whitney Wolfe Herd speaking to the New York Times’ Lulu Garcia-Navarro about injecting artificial intelligence into dating apps: “[Garcia-Navarro] How are you imagining A.I. functioning in this next iteration of the app? [Herd] Let’s say we could train A.I. on thousands of what we perceive as great profiles, and the A.I. can get so sophisticated at understanding: “Wow, this person has a thoughtful bio. This person has photos that are not blurry. They’re not all group photos. They’re not wearing sunglasses. We can see who they are clearly and we understand that they took time.” The A.I. can … Read More

The $200 Billion Gamble: Bill Gates’s Plan to Wind Down His Foundation

“[David Wallace-Wells] Were you surprised by the cruelty? [Bill Gates] The reductions to U.S.A.I.D. are stunning. I thought there’d be, like, a 20 percent cut. Instead, right now, it’s like an 80 percent cut. And yes, I did not expect that. I don’t think anybody expected that. Nobody expected the executive branch to cut PEPFAR or polio money without the involvement of Congress. What’s going on with H.I.V. research and trial networks, I didn’t expect that either. We will do our best to get these things changed. I will be an advocate. But those are real headwinds. And what’s Congress … Read More

An umbrella review of efficacy of digital health interventions for workers

“[Abstract] Efficacy of digital health (d-Health) interventions on workers’ physical activity (PA), sedentary behavior, and physiological outcomes remains unclear. This umbrella review searched PubMed, Cochrane Library, and Google Scholar up to October 25, 2024. We identified 24 systematic reviews (SRs) and selected 130 individual studies from these SRs for analysis. The AMSTAR 2 tool rated the quality of most SRs as critically low. Narrative syntheses suggested that d-Health interventions could potentially improve all outcomes compared with no intervention. However, whether d-Health interventions outperform non-d-Health interventions remains uncertain. Meta-analyses showed a significantly small effect of d-Health interventions on step counts, sedentary/sitting … Read More

Reducing the Over-Diagnosis of Thyroid Disease

“Symptoms of hypothyroidism are nonspecific and poorly predict clinically significant thyroid dysfunction, especially in patients with underlying medical conditions and advanced age. Thus, it is essential to identify thyroid dysfunction before initiating therapy. Yet, it is estimated that about 30% of persons newly started on l-thyroxine treatment in the United States have normal thyroid function. When symptoms result in ordering thyroid function tests, an elevated thyroid-stimulating hormone (TSH) level should not trigger therapy without confirmatory TSH and free thyroxine (FT4) levels. Symptoms associated with overt hypothyroidism (elevated TSH, low FT4) usually resolve with l-thyroxine replacement, but therapy for subclinical hypothyroidism … Read More

General AI May Revolutionize Neurology—Or It Might Be Bad

“The chief risk of developing general AI [artificial intelligence] too rapidly is misalignment—when an AI system’s objectives diverge from human values. The AI research community has identified several considerations that increase misalignment risk, illustrated in the Box using neurology-specific examples. These illustrative cases might seem straightforward to detect and correct. However, if we succeed in developing a general AI that far exceeds human intelligence, the stakes become higher and intervention more difficult. In neurology, superintelligent AI could become essential for tasks like diagnosing conditions, personalizing treatments, managing hospitals, and making critical decisions. If a superintelligent AI conceals misalignment, however, it … Read More

Toward Defining Problematic Media Usage Patterns in Adolescents

“In the case of substance abuse, decades of research established a taxonomy that is more nuanced than simply alcohol abuse vs use. The National Institute of Alcohol Abuse and Alcoholism has established different usage patterns that have been studied both for their independent effects on functioning and how each might ultimately lead to the clinical entity of alcohol use disorder (Table). We propose an analogous taxonomy for digital media use that identifies patterns of use, irrespective of content, that could be problematic but, at a minimum, should be flagged as warranting further evaluation and potential remediation. Although in this Viewpoint … Read More