4 times Dutch Delight and a Poll

Regularly I discuss recent articles about different subjects related to medicine, psychiatry and education among other subjects. The choice of articles is completely biased. It is because I think the subject is interesting, the research design is elegant or creative, the research question is relevant, or the results are important or any combination of these characteristics. Sometimes, also to my own surprise, these articles are written by Dutch authors.
This blog now exists for 9 months and it is almost the end of the year. Time to look back on these articles written by Dutch authors and to select the best ones. The articles I appreciated the most. This selection is completely arbitrary based on my personal preferences but nevertheless here they are:

1. The use of SSRIs and venlafaxine among children and adolescents in Dutch general practice decreased between 2001 and 2005. A point of concern is the high percentage off-label prescribing of SSRIs and venlafaxine in 2005 as compared to 2001. Not very creative kind of research but very practical with a clear message: Watch out for prescriptions of off lable drugs in children. I hope they will look into this matter in the near future.

2. A disappointing conclusion in this meta analysis: Efficacy of Internet based Cognitive Behavioral Therapy (CBT) for depression and anxiety disappointing. In a recent meta-analysis CBT for depression and anxiety was modestly effective compared to placebo, care as usual, or waiting list conditions. There was also a significant heterogeneity between trials. In short the trials are different and hard to compare.

3. Bold statements mostly done by senior staff members during grand rounds about material that is less well known occurs frequently. Such bold statements are frequently articulated with great conviction and are usually accepted and assimilated by junior staff and the likes of them.
In this article the authors found only 8 (32%) statements to be supported by scientific evidence. In 17 (68%) statements the available literature contradicted (n=13) the statement, or no literature was avalable (n=4). A lot of bull doe ushered during Grand Rounds.

4. 38 of 50 elderly patients refused randomisation beforehand in this trial because of fear of electroconvulsive therapy (ECT). An in depth interview showed that fear of brain damage by ECT played a major role. This recently published study was a feasibility study testing the efficacy and safety of ECT, prescribed in an earlier phase of treatment than last resort. This study would test the efficacy of ECT versus nortrityline among depressed elderly (> 59 years) who had not responded to sertraline, a selective serotonin reuptake inhibitor (SSRI). The wrong assumption that ECT causes brain damage might be a vestige of the seventy’s and the dark period of the anti psychiatry in the Netherlands in that same period.

Which of these articles did you like the most, take the poll on the top right,

Regards Dr Shock.