2 Minute Medicine Rewind July 27th, 2026 

Digital Mental Health Treatment and Symptoms of Depression and Anxiety in Breast Cancer Survivors

1. Among a large cohort of breast cancer survivors, those who participated in digital mental health treatment reported a reduction in symptoms of anxiety, with additional human coaching associated with a reduction in depression.  

Evidence Rating Level: 1 (Excellent)

Almost 50% of all women suffering from advanced breast cancer experience significant anxiety and depression within the first year from their diagnosis. These symptoms are associated with poor quality of life, increased economic burden, and higher mortality. In this randomized controlled trial, 313 women with breast cancer were randomized in a 2:1 ratio to receive digital mental health treatment (DHMT) program or a standard patient education program to study the effect of a hands-free, accessible, virtual therapeutic service. The digital mental health treatment program consisted of an 8-week virtual, human-coaching psychoeducation application. Breast cancer patients reported significantly less anxiety symptoms than those in the patient education group (p=0.01), but did not report statistically significantly reduced depression symptoms (p=0.06). The study opted to further analyze the difference between those who reported optimal engagement in the DHMT program vs those who reported a less regimented use of the program. At baseline, those who reported optimal engagement (n=134) outnumbered those who did not (n=72), and those with suboptimal engagement who sought out additional coaching during their DHMT program reported significantly reduced depression symptoms compared to those who did not seek additional coaching (p<0.001). Overall, the study findings suggest that an interactive digital health program provides a more accessible approach for breast cancer survivors to seek support for anxiety symptoms, while the addition of human coaching to the digital intervention may further improve symptoms of depression.

Hormonal Contraception and Initiation of Semaglutide Therapy

1. Among a nested case-control study, use of hormonal contraception was associated with higher subsequent semaglutide initiation for weight control among women of reproductive age. 

Evidence Rating Level: 1 (Excellent)

Weight changes and metabolic symptoms are common side effects associated with hormonal contraception available for women of reproductive age. In patients where these changes are undesirable, stopping the contraception or finding alternative methods to weight control may be utilized. Semaglutide, an GLP-1 receptor agonist, is a high effective and recently popular pharmacologic method for weight loss. In this case-control study, 22694 semaglutide users and 229640 controls were identified across Danish national registries of females aged 12-49 years from 1996-2023. Semaglutide initiation was associated with all methods of hormonal contraceptive use, with adjusted hazard ratios (AHR) ranging from 1.42 (95% CI, 1.34-1.51) for combined oral tablets, 1.63 (95% CI, 1.46-1.82) for progestin-only IUDs, 1.64 (95% CI, 1.47-1.82) for combined oral tablets followed by progestin-only oral tablets, and 2.11 (95% CI, 1.97-2.25) for other utilization patterns of two or more types of contraception. Overall, this study found that semaglutide initiation was more strongly associated with female patients who had previously used hormonal contraceptives, suggesting that concerns about weight gain and weight management related to hormonal contraceptive side effects may influence treatment-seeking among individuals of reproductive age.

Drinking Water Contaminant Exposures and Risk of Uterine Cancer

1. In a large cohort study, an increased risk of uterine cancer was found in women with enrollment addresses linked to a community water supply with known tap water contamination, with the highest risks associated with trihalomethanes and haloacetic acids exposure, and little to no risk associated with nitrate, arsenic, or uranium levels.

Evidence Rating Level: 2 (Good)

Uterine cancer is the most diagnosed gynecologic cancer, where almost 95% of all uterine cancer cases consists of endometrial cancer. Tap water remains a major source of exposure to carcinogenic contaminants in many communities. This cohort study evaluated 53100 women who lived in a known jurisdiction with contaminated tap water for 10 years or longer. Incident uterine cancers were identified through the California cancer registry. Higher levels of trihalomethanes in tap water were associated with higher risk of uterine cancer, with hazards ratio (HR) = 1.18 (95% CI 1.02-1.38, P=0.06), specifically with endometrial tumours (HR=1.23, 95% CI 1.05-1.46, p=0.01). High levels of haloacetic acids in tap water were also associated with higher risk of uterine cancer, but with nonendometriod tumours (HR=1.86, 95% CI 1.06-3.25, p=0.01). No associations were observed with levels of nitrate, arsenic, or uranium in tap water. Overall, this study provides evidence that greater exposure to trihalomethanes and haloacetic acids in drinking water is associated with an increased risk of uterine cancer. These findings underscore the public health importance of monitoring drinking water for these contaminants and implementing strategies to reduce exposure across communities.

Cognitive Rehabilitation and Functional Outcomes in Long COVID-Related Cognitive Impairment

1. In a multicenter, single-blind, randomized clinical trial, participation in a cognitive rehabilitation program improved goal attainment and cognitive test scores in patients suffering from Long COVID-related cognitive dysfunction.

Evidence Rating Level: 1 (Excellent)

Long COVID is defined as a chronic condition that occurs following the infection of COVID-19, present for at least 3 months consisting of symptoms of disease among 1 or more organ systems. More than 27% of COVID-19 survivors report cognitive impairment, with deficits in goal attainment, executive functioning, memory, language abilities, processing speed, and extensive fatigue. This study conducted a multicenter, single-blind, randomized control trial with 78 patients allocated in a 1:1 ratio to a new cognitive rehabilitation program of 10 weekly 1-hour telehealth sessions that focused on achieving 3 defined goals, compared to treatment as usual. Three months after randomization, goal achievement was significantly greater in the cognitive rehabilitation program compared to treatment as usual (adjusted mean difference=2.88, 95% CI 2.03-3.73, p<0.001). These effects were maintained at 6 months post-implementation of the cognitive rehabilitation program compared with the treatment as usual group (adjusted mean difference=1.72, 95% CI 0.86-2.57, p<0.001). Overall, this study highlights the effectiveness of individualized, goal-oriented cognitive rehabilitation in improving goal attainment and reducing cognitive impairment among patients with Long COVID, with improvements evident in the short term and sustained over the long term.

Medication and Procedural Abortion and Risk of Psychotropic Medication Use

1. Among a Danish population-based cohort study, increased initiation of psychotropic medication in the first year following both medical and procedural methods of abortion were found, with decreased risk of initiation of psychotropic medication within five or more years following both medical and procedural abortions. 

Evidence Rating Level: 2 (Good)

There is limited research on whether medical or procedural abortion methods increases the risk of mental health issues requiring psychotropic medication. In this cohort study, 67390 females born between 1980 to 2006 and who received a first trimester abortion between 2000 to 2018 were identified. 33793 of these women received a medical abortion, while 33597 received a procedural abortion. There was an increased risk of first psychotropic medication use associated with the first year after a medical abortion, with incidence rate ratios (IRR) being 1.10 (95% CI, 1.02-1.19, p = 0.01), as well as within the first year after a procedural abortion (IRR =1.11, 95% CI, 1.02-1.22, p = 0.02). There was decreased risk of first psychotropic medication initiation more than 5 years afterwards for both medical abortion (IRR=0.83, 95% CI, 0.76-0.92, p<0.001) and for procedural abortion (IRR=0.92, 95% CI, 0.85-0.99, p=0.03). Overall, this study found no evidence that worsening mental health requiring psychotropic medication was more strongly associated with one abortion method than another. Any increased likelihood of psychotropic medication initiation was concentrated within the first year following an abortion, with no significant association observed five years later.

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