The Week in Review: April 8-12

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This week, Psychiatric Times® discussed a wide variety of psychiatric issues and industry updates, from a look at record-high suicide rates to subspecialty shortages in psychiatry.

Rejoyn: A Fundamental Change in How Clinicians Can Treat MDD Symptoms

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Rejoyn (CT-152) recently became the first prescription digital therapeutic authorized for the treatment of major depressive disorder (MDD) symptoms as an adjunct to clinician-managed outpatient care for adult patients with MDD aged 22 years and older who are on antidepressant medication. Rejoyn is expected to be available for download later in 2024. In the meantime, Psychiatric Times sat down with John Kraus, MD, PhD, executive vice president and chief medical officer at Otsuka, to learn more.

PT: Can you describe Rejoyn in your own words? How and why is it effective?

John Kraus, MD, PhD: Rejoyn (developed as CT-152) is a 6-week treatment intended to reduce MDD symptoms, delivered via smartphone app. Rejoyn is designed to help enhance cognitive control of emotion through a combination of clinically-validated cognitive emotional training exercises for the brain and brief therapeutic lessons. In the Mirai study, individuals treated with Rejoyn showed an improvement in depression symptoms from baseline. Continue Reading

A Year of Record-High Suicide Rates

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According to new data from the US Centers for Disease Control and Prevention, the suicide rate in the United States recently reached its highest peak since 1941. The provisional number of suicides in 2022 was 3% higher than the final total number of suicides in 2021—and the 2022 final total number of suicides is likely higher than current counts. What can we learn from these statistics?

Exploring the Trends

“Is this really an out-of-the-blue story, and are we surprised by the rise? Or is this that steady rise that we have continuously seen over the years?” Fuad Khan, MD, a psychiatrist in Dover, New Hampshire, who is affiliated with multiple hospitals in the area, including Wentworth-Douglass Hospital and Massachusetts General Hospital, told Psychiatric Times. Continue Reading

Subspecialty Shortages: Is Psychiatry in Need of a Cultural Defibrillation?

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The United States is in the midst of a mental health crises and the aftermath of the COVID-19 pandemic on mental health continues to reverberate. Unfortunately, only about half of those struggling with mental illness receive treatment and this is exacerbated by the deficit in the number of psychiatrists needed to meet public demand. Even worse, however, are the shortages seen among psychiatry subspecialists with only 27.7% of counties having at least 1 child and adolescent psychiatrist, 10.5% having a geriatric psychiatrist, and 7.6% with an addiction psychiatrist.

Despite growing interest among medical students to pursue psychiatry residency training, this interest has not resulted in an increase in fellowship matches for subspecialty training. Reasons for this are multifactorial, with residents reporting the extended duration of training and financial concerns as primary deterrents. As a result, a significant portion of fellowship positions go unfilled every year. Continue Reading

The Fine Art (and Science) of Nonprescribing

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In my career as a psychopharmacology consultant for over 25 years, much of the advice I gave to consultees involved discontinuing unnecessary medications, or at least greatly reducing the dose—a practice now termed “deprescribing” and originally applied to geriatric medicine. Deprescribing is usually defined as “reduction or cessation of medications for which benefits no longer outweigh risks,” and is comprehensively reviewed in an excellent paper by Gupta and Cahill.

In this article, however, I reflect on the art and science of medication nonprescribing, and the use of psychotherapy as initial or first-line treatment. Definitions of “first-line” differ, but as I use the term, it refers to a therapeutic intervention recommended for initial treatment, based on proven efficacy and tolerability in controlled, clinical studies. Accordingly, there may be more than 1 first-line agent or treatment for a given condition. Continue Reading

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