Mental health took centre stage at the Jewish General Hospital’s 13th Annual Psychiatry Research Day on April 6, as healthcare and social service professionals from across Montreal learned about the latest developments in psychiatry research at the hospital. Speakers from the Lady Davis Institute addressed the theme, Connecting Mind and Body: Psychosocial interventions in the context of treating physical disease.
Giving meaning to life in advanced cancer patients
A cancer diagnosis can often trigger existential distress, according to Dr. Melissa Henry, a Psychologist at the JGH Segal Cancer Centre whose research investigates how to enhance meaning in the lives of people with advanced cancer.
“When you’re diagnosed with cancer, it’s a huge life disruption,” Dr. Henry says. “For many, it’s their first confrontation with their own mortality.” That’s why it is not uncommon to find higher levels of depression, anxiety and existential distress, especially in those with advanced cancer.
Dr. Henry studies the effectiveness of Meaning-Making Intervention (MMi) in helping patients explore the meaning of their cancer diagnosis, their lives, and of life in general. “The goal is to reduce the initial emotional distress, and open up a space for people to think about what it means to be diagnosed with cancer,” says Dr. Henry. The intervention is typically delivered in one to four sessions involving three tasks:
- The present: Revisit the cancer diagnosis, and what it means to the participant
- The past: Revisit past challenges and traumas, past coping strategies, and find meaning through those events
- The future: Re-establish a sense of commitment towards life goals in the face of uncertainty and limitations
Dr. Henry is co-piloting a study to determine the efficacy of MMi in advanced cancer patients with stage three or four cancer. Previous research with stage one or two cancer patients has shown increased levels of self-esteem and optimism following participation in the program.
The research will assess whether MMi can enhance meaning in the lives of cancer patients, improve their overall quality of life, and decrease their levels of psychological distress after two, four and six months, when compared to standard care, and standard care alongside meetings with an empathic visitor.
There are currently 471 people enrolled in the study. Dr. Henry is continuously looking for participants in her MMi research. She can be contacted at melissa.henry@mcgill.ca.
Using meditation to combat late-life mental illness
By 2030, half of the population will be over 60 years of age. “We need to know more about how to help older adults,” says Dr. Soham Rej, a Geriatric Psychiatrist in the JGH Department of Psychiatry. Dr. Rej is investigating how Mindfulness Meditation can help treat late-life mental illness. To that end, he is conducting a multi-site randomized control trial with older hemodialysis patients who have symptoms of depression and anxiety.
Approximately half of hemodialysis patients suffer from depression and anxiety symptoms, with about 20 per cent meeting the criteria of a disorder, he says. “These symptoms have been linked to a lower quality of life, and increased non-adherence to hemodialysis.”
Mindfulness Meditation has shown to be effective in treating psychiatric conditions such as depression and substance abuse, as well as physical illnesses like cancer and diabetes.
In his study, Dr. Rej is comparing the effects of Mindfulness Meditation to a Health Enhancement Program Active Control. Patients will have two, 20-minute meditation sessions per week, for a total of eight weeks. They will also be asked to practice meditation daily for 15 minutes.
Researchers will be looking for improvements in depression and anxiety scores, sleep quality and psychosocial distress in patients.
“Meditation is a skill,” says Dr. Rej. “We learn to focus on being aware of the present moment and do so without judgment. It teaches us to take a step back and say, ‘I’m alive.’”
Accessible materials for people with rare diseases
As Founder and Director of The Scleroderma Patient-centered Intervention Network (SPIN), Dr. Brett Thombs’s research focuses on developing strategies to improve quality of life and reduce disability among people living with scleroderma. Scleroderma is a rare autoimmune disease causing the formation of scar tissue in the skin and severe vascular problems, affecting one in 5,000 to 6,000 people worldwide.
“The crucial experience of having a rare disease is being alone,” said Dr. Thombs, who is also a Senior Investigator at the JGH Lady Davis Institute. “You’re told you have a disease, but you’ve often never heard of it nor met someone with it. There is also a scarcity of services or supportive care.”
SPIN is an organization of researchers, healthcare providers and scleroderma patients from all over the world. Its goal is to develop, test, and disseminate free online educational, self-management, psychological, rehabilitation, and support tools to people with scleroderma. The organization has created five web-based modular patient programs developed by experts, covering areas such as managing symptoms and emotions related to scleroderma. “The programs teach skills to cope with the disease, and helps patients feel confident to take on tasks that are important to living better,” Dr. Thombs said.
SPIN has recruited nearly 2,000 patients with scleroderma from over 45 sites and seven countries.
Two of SPIN’s programs have been funded for randomized control trials of 500 to 600 people to determine their efficacy. SPIN Hand, a hand exercise program, provides patients with exercises to improve hand function and mobility, a common problem in scleroderma patients. The Self-Management program includes online modules geared to help patients cope with appearance changes and such symptoms as pain, fatigue and stress.
