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Mar 24 • 5 tweets • 3 min read
We are honored to welcome Dr. Holly Swartz, Prof of Psychiatry at @PittPsychiatry & Editor-in-Chief of American Journal of Psychotherapy (@APA_Publishing) to @uwsmph @UWHealth Psychiatry Grand Rounds to discuss:

"Psychosocial Interventions for #Bipolar Disorder"

#PsychTwitter Image
Network meta-analysis indicated that psychotherapy, including CBT, family focused therapy, and interpersonal & social rhythm therapy (IPSRT), are effective interventions for bipolar depression and for prevention of recurrence of bipolar disorder.

ncbi.nlm.nih.gov/pmc/articles/P… Image
Core strategies of bipolar-specific psychotherapies (cognitive therapy, family therapy, interpersonal & social rhythm therapy, psychoeducation & integrated care management): Image
Pilot study suggests effectiveness and acceptability of web-based social rhythm therapy in bipolar disorder (RAY = Rhythms Are You) with a "clinical helper":

ncbi.nlm.nih.gov/pmc/articles/P…
Online training for interpersonal & social rhythm therapy is here: ipsrt.org/training

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More from @artwalaszek

Art Walaszek Profile picture
Mar 25
Americans’ life expectancy is plummeting. The graphic is stunning.

“American life expectancy is lower than that of Cuba, Lebanon, and Chechnya.”

#MedTwitter

npr.org/sections/healt… Image
Why?

“Yes, Americans eat more calories and lack universal access to health care. But there's also higher child poverty, racial segregation, social isolation, and more. Even the way cities are designed makes access to good food more difficult.”
Interestingly, the US “has higher rates of cancer screening and survival, better control of blood pressure and cholesterol levels, lower stroke mortality, lower rates of current smoking, and higher average household income.”

But it’s not enough to offset the many other factors.
Read 8 tweets
Art Walaszek Profile picture
Apr 2, 2022
1- My current take on whether anti-amyloid therapies are likely to have meaningful impact on cognition, functioning & quality of life of people living w/ #dementia due to #Alzheimers disease:

Not likely.

For details, based on my recent Grand Rounds at Penn St, read on.
2- History:

After finding that active immunization with Abeta42 in mice that overexpressed APP resulted in virtual elimination of amyloid deposits, there was great enthusiasm for anti-amyloid therapies - and for the amyloid hypothesis.

pubmed.ncbi.nlm.nih.gov/10408445/
3- More history:

Unfortunately, active immunization with Abeta42 in humans resulted in unacceptable side effects.

Passive immunization with various anti-amyloid monoclonal antibodies failed in multiple studies.

It seemed like this was the end of the line, until ...
Read 17 tweets
Art Walaszek Profile picture
Apr 2, 2022
1- Detailed & persuasive critique by Dr. @LonSchneiderMD of the #aducanumab esults recently published in the J of Prevention of #Alzheimers Disease.

#GeriTwitter

link.springer.com/article/10.142…
@LonSchneiderMD 2- Note that the assn. between amyloid reduction & cognition goes in opposite directions in the 2 studies:

"High dose aducanumab was about as cognitively impairing in ENGAGE as it was beneficial in EMERGE [despite] both trials showing similar, substantial reductions in plaque."
3- It's also possible that the slight cognitive improvement found with high-dose aducanumab in EMERGE was due in part to the greater worsening of cognition in the placebo group of EMERGE compared with the placebo group of ENGAGE.
Read 4 tweets

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