Perspectives on the Efficacy of Antidepressants for Child and Adolescent Depression

Raz looks at the ongoing controversies surrounding the use of SSRI antidepressants in children

Patterns of Bronchial Challenge Testing in Canada

Background: Bronchial challenge testing (BCT) measures airway hyperresponsiveness; asthma guidelines recommend using BCT when symptoms manifest despite normal spirometry. Improper application of these guidelines commonly results in the misdiagnosis of asthma. Yet, statistics concerning BCT remain largely obscure. The current paper addresses this gap and explores how various health variables may elucidate adherence to asthma guidelines and patterns of BCT across Canadian provinces. Methods: Using the Access to Information Act, medical financial claims for BCT (or equivalent procedures) were requested from each of the Canadian provinces and territories. Based on the available information (from provinces only), correlations between frequency of BCT claims and medical demographics (e.g., prevalence of respirologists, health expenditures) are reported. Results: Controlling for population or for people with asthma, physicians from Québec claim four times more BCT per year than those in other provinces; physicians from Alberta close to eight-fold fewer. The number of respirologists per capita and BCT per capita correlated moderately, r(132) = 0.582, p \u3c 0.001, [95% CI 0.421, 0.716]. Excluding “outliers” (i.e., British Columbia, Alberta, and Saskatchewan) greatly strengthened this correlation, r(87) = 0.930, p \u3c 0.001, [95% CI 0.883, 0.958]. Discussion: These findings demonstrate that provinces vary in their use of BCT. This result seems to stem, at least in part, from differences in the prevalence of respirologists. Interestingly, geographic region appears to wield a strong influence; in the correlation between number of tests and number of respirologists, physicians from Western provinces (i.e., Alberta, Saskatchewan, and British Columbia) administered fewer tests than their Eastern colleagues. Given the association between inadequate application of BCT and misdiagnosis of asthma, physicians should pay special attention to the Canadian guidelines when considering an asthma diagnosis

Hypnosis and meditation: Vehicles of attention and suggestion

Although hypnosis and meditation represent distinct domains of practice, they appear to overlap in phenomenology, cognitive mechanisms, neural substrates, and potential therapeutic merits. Whereas numerous studies have documented the beneficial impact of these approaches, few have harnessed these distinctive phenomena together, either clinically or as a means of illuminating cognitive questions. This paper introduces the theme of the present issue and discusses the potential value of yoking empirical studies of hypnosis and meditation. The marriage of these seemingly disparate yet overlapping practices promises to improve our scientific understanding of each as well as unravel their underlying mechanisms. On the one hand, albeit largely overlooked by researchers studying meditation, the intimate relationship between attention and suggestion holds important implications for both theoretical models and therapeutic applications of contemplative practice. On the other hand, hypnosis and meditation serve as complementary vehicles for elucidating salient topics in cognitive neuroscience, including the neural underpinnings of perception and cognitive control, and the governing of deeply-ingrained processes. Binding these approaches to the science of attention and suggestion paves the road to a more nuanced appreciation of hypnosis and meditation while fostering novel therapeutic prospects and improving our understanding of consciousness and cognition