There are situations that come up in a primary care setting when a pediatric (and some adult patients) presents with symptoms that are compatible with a diagnosis for Attention Deficit Hyperactivity Disorder (ADHD) but where there are concerns about prescribing a stimulant medication. These are some of the situations when this can occur: 1. The […]

Mental health concerns can occur in the postpartum period, and depression is the most common mental health concern that is seen. Previous e-Weekly’s have discussed the effects of postpartum depression on a new mother and her bonding with her baby. It is not uncommon for a new mother to feel like she has to make […]

Millions of prescriptions are written every year for benzodiazepines which can be important therapeutic agents. In a large percentage of these cases, the provider is uncomfortable with the prescription. For this reason and many others, it is important to have a good understanding of when it might be appropriate to prescribe a benzodiazepine for a […]

Most children can have oppositional and defiant behavior (this is developmentally appropriate in young and latency age children) but that does not mean they qualify for a diagnosis of ODD. The key is that it has to be pervasive and across settings to consider a diagnosis of ODD. It also has to be present in […]

In Part 1 of this 2 part series, we will discuss what Oppositional Defiant Disorder (ODD) is and how to diagnosis and treat it. The second part of this series will discuss in more detail the differential diagnosis for ODD and begin the discussion about if the diagnosis is over used in clinical practice. Oppositional […]

Is this Bipolar Disorder? Case Presentation: 24 year old female who meets criteria for a major depressive episode is started on fluoxetine and titrated to 20mg per day. Depressive symptoms include: sad mood, hypersomnia, fatigue, poor concentration, hopelessness, and crying spells for 1 month, and the symptoms are impacting her functioning at work. She tolerated […]

Rates of cigarette use are higher in persons with mental illness compared with those without mental illness, according to a federal survey conducted by the Centers of Disease Control (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). According to the report, about 1/3 of those with mental illness were current smokers compared […]

LGBTQ youth have a lot of hurdles to overcome, with the pressures of coming out, dealing with harassment and bullying, and trying to find acceptance in the world surrounding them. In part because of these stressors, they may be at higher risk for a variety of mental health concerns. So when working with an LGBTQ […]

Motivational interviewing (MI) is a technique that can be applicable to all clinical settings including primary care. MI is defined as “a person-centered, goal-oriented approach for facilitating change by exploring and resolving ambivalence” (Miller 2006). It can be useful in situations when a patient’s behavioral choices negatively impact his health condition – examples include smoking, […]

Psychological and physiological dependence on benzodiazepines can occur in as little as two weeks of daily moderate use. It can occur in the most benign of clinical situations, and it is important for providers to be aware of the risk for dependence when prescribing this class of medications. If a patient has been on a […]