Symptom Relief and Quality of Life in Autistic Children Using Medical Cannabis: A Secondary Analysis
Wendy J. Ross, MD, FAAP; Jennie Ryan; Madalene Zale; and Alexander Fossi, MPH
- This study aimed to examine the experiences of parents and caregivers of autistic children who used medical cannabis (MMJ) for the treatment of core symptoms or co-occurring conditions
- Considered priorities and outcomes of medical cannabis use, including: 1) Quality of life (QoL) effects; 2) Symptoms of interest; 3) Symptoms of co-occurring conditions
Effects of Using Different Death Rate Metrics on the Analysis of Drug-Overdose Death Rates and Socioeconomical Factors
William R. Duan and Dennis J. Hand
Age-adjusted death rate (AADR) and raw death rate (RDD) used in drugoverdose studies typically involves death-record data and populationsurvey data. Difference can exist between the two data sources, leading to the so-called dual data-source error. Proportionate mortality avoids the error; however, no studies have been done comparing the conclusions drawn using the different metrics. The objective of this study is to evaluate the differences and merits of using different death-rate metrics in overdose analysis.
William R. Duan and Dennis J. Hand
The objective of this study was to investigate the dependencies of opioid overdose death rates on the day of the week and understand the implications of the dependencies Understanding and presenting the dependencies is useful for first responders and for health care system resource planning It can provide additional insights in the opioid epidemic and should be considered in prevention efforts
Connie Chang, MD and Aneela Khan, MD
To recognize the importance of taking a system of care approach to determine whether the symptoms of school avoidance are due to mental illness
Hephsibah Loeb, MD and Ann Chandy, MD
In 2017, the FDA approved the first app for treatment of alcohol, cocaine, marijuana and stimulant use disorders. In a preceding randomized controlled trial, mobile software Therapeutic Education System (TES) was found to reduce dropout from treatment and to increase patients’ rates of abstinence from substance abuse. Another study showed that PRIME-D, a mobile-based treatment for depression, positively affected symptoms of depression and disability. Many individuals seek out self-help apps for psychiatric complaints, although, in general, little evidence exists for evaluation of the most accessible mobile apps for self-help. What are the strengths and weaknesses of digital apps for treatment of mental illness? How should a mental health clinician assess the role and efficacy of mobile apps within a patient’s treatment? Results of TES trial include lower dropout rate and greater abstinence rate from non-opioid substance abuse. Through use of PRIME-D, individuals were found to have improvement in self-reported depression and self-reported disability. Both TES and PRIME-D trials involved a clinician or coach alongside the mobile intervention. Patients in the PRIME-D study who had greater interaction with masters' level mental health coaches were more likely to have greater improvement in mood symptoms. The high level of retention in study was also thought to be related to human support from mental health coaches. Self-help apps for mental health can increase access to care, without barriers such as clinician availability or clinic hours. Lower cost and convenience could increase adherence. Psychoeducational information can be accurately provided, without risk of faulty administration by staff. The potential for a mobile app-based approach to treatment can reduce stigma and thus increase the likelihood of a patient seeking to address mental illness. Significant drawbacks of self-help apps for mental health include the concerns about privacy of data shared on apps. Apps can provide information that is inappropriate, incorrect or that may be misinterpreted by individual users. Apps may not be suitable for emergency situations and may not be easy to use by patients who have serious mental illness. Developed by the American Psychiatric Association, the APA App Evaluation model provides a means for clinicians to evaluate apps for mental health. The model employs a five-tiered system for assessing background information, privacy and security, clinical evidence, ease of use, and potential to share data with the clinical team. In conclusion, evidence from two interventions shows that mobile apps can improve outcomes in patients with non-opioid substance use disorder and depression. Digital apps for mental health can allow increased access to mental health resources; however, also have significant drawbacks related to privacy, the risk of misinformation, and inadequacy in an emergency.
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