“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
All posts in Epidemiology
“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
“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
“There were 26.4 deaths per 100,000 people from diabetes, according to early death certificate data for the third quarter of 2024 published this month by the CDC’s National Center for Health Statistics. Death rates from diabetes peaked in 2021, according to CDC figures, at 31.1 deaths per 100,000 people for that year. Diabetes was the eighth leading cause of death in 2021. The CDC says the link between COVID-19 and diabetes may be to blame for that increase. “Data show an increase in mortality rates for all people during the COVID-19 pandemic, and research shows that people with underlying conditions, … Read More
“[Introduction] Despite spending more than any country in the world on health care, life expectancy in the US is comparably worse than that of most other high-income countries and declining both in absolute value and relative rank. However, life expectancy across US states varies just as markedly as it does across high-income countries, from 81.8 years in Hawaiʻi to 74.7 years in Mississippi in 2019—a divergence that has been increasing over time. US states vary considerably on policy decisions related to the spending, regulation, and provision of health care; reproductive health; tax policy; social welfare programs; and in relation to … Read More
“most people don’t simply want to live until 110. They want to extend the amount of time they live free of serious disease, a concept known as health span. That’s why the most sensible approach is to reduce the toll of three major age-related diseases: cancer, heart disease and neurodegenerative disorders, such as Alzheimer’s disease. It may be less flashy, but it’s more attainable than ever. It’s estimated that at least 80 percent of cardiovascular disease cases, 40 percent of cancer cases and 45 percent of Alzheimer’s cases are preventable. Even with a long lag — these diseases can each … Read More
“Ruane and colleagues1 address a pressing and timely issue: the intersection of olfactory impairment (OI) and aging-related outcomes. [..] The growth in the prevalence of older adults brings substantial societal, economic, and public health implications, making the detection and prevention of risks in this group essential. Olfaction appears to be a unique canary in the coal mine. [..] At 6 years, dementia emerged as the predominant mediator, accounting for 23% of the OI-mortality association, followed by frailty at 11% and malnutrition at 5%. By 12 years, however, the influence of dementia and malnutrition waned, leaving frailty as the sole significant … Read More
“[Green] I was really surprised to learn that tuberculosis is the deadliest infectious disease in the world. Even though I cared about global health, I would have bet my life that it was malaria or H.I.V., because those diseases get so much more attention. They still don’t get nearly enough attention, it must be said; people don’t pay enough attention in the rich world to problems in the global South. [..] It’s not easy to cure, but neither was my brother’s cancer. My brother had cancer a couple of years ago; it cost about 150 times more to cure than … Read More
“In 1990, it was hypothesized that humanity was approaching an upper limit to life expectancy (the limited lifespan hypothesis) in long-lived populations, as early gains from improved public health and medical care had largely been accomplished, leaving biological aging as the primary risk factor for disease and death; the rate of improvement in life expectancy was projected to decelerate in the twenty-first century; and e(0) [life expectancy at birth] for national populations would not likely exceed approximately 85 years (88 for females and 82 for males) unless an intervention in biological aging was discovered, tested for safety and efficacy and broadly … Read More
“Why would more screening in both Black and white Americans reduce the mortality disparity between the two groups? What’s more, cancer screening actually stands out for its lack of racial disparity. The proportion of Black and white women having mammograms has been virtually identical for the past three decades (in fact, Black women currently have the test at slightly higher rates). Yet deaths from breast cancer are about one-third higher in Black women. For the past two decades, a similar pattern has been seen in colorectal cancer screening — equal rates among Black and white Americans — yet colorectal cancer … Read More