SMARTer CARE Newsletters
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Psychiatry and Chronic Pain
Pain affects nearly 100 million people and is one of the most common complaints made to primary care providers by their patients. More than 20% of all medical visits are pain-related. Consistent with a biopsychosocial model of illness, individuals with chronic pain often report that the pain interferes with their ability to engage in occupational […]
Medical Differential for Patient Presenting with Depressive Symptoms
When a patient, especially one without a history of depression, presents with depressive symptoms, it is important to consider if those symptoms are a result of another medical condition. Depressive symptoms that are more likely to be in this category include: Fatigue/low energy Trouble initiating or maintaining sleep Hypersomnia Significant change in […]
“Hallucinations” in Children
Hallucinations in children can be a confounding symptom and it is important to evaluate further if a child is presenting with concerns about hallucinations. It is important to distinguish among true hallucinations (false auditory, visual or other sensory perceptions that are not associated with real external stimuli), illusions (misperceptions of actual stimuli), imaginary friends, fantasies […]
Breaking Confidentiality with Confidence
While privacy and confidentiality issues are paramount parameters in all healthcare interactions, it is not uncommon for providers to feel constrained at critical moments by these concerns. A recent consult received on our provider triage line [(858) 880-6405] involved a single, middle aged gentleman who had presented on his own steam to a clinic with […]
Extra-Pyramidal Symptoms (EPS)
Extra-Pyramidal Symptoms (EPS) refers to involuntary motor movement side effects that can result from antipsychotic use. EPS is generally less likely to occur with second generation antipsychotic medications (Risperdal, Seroquel, Abilify, Geodon, Zyprexa, Latuda) compared to first generation antipsychotic medications, especially the high potency ones (Haldol, Prolixin, Trilafon). It is important to monitor for EPS, […]
Tips to Reduce the Side Effects of ADHD Medications
Medications for Attention Deficit Hyperactivity Disorder (ADHD) can be very helpful for children who struggle with hyperactivity, impulsivity, and inattention so that they can be more successful in the home and school environments. Often these medications can lead to problematic side effects such as decreased appetite, stomach pain, sleep problems, and moodiness, that can make […]
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a mental disorder than can occur after a person is exposed to a major traumatic event. It is classified as a “trauma and stress-related disorder” in the DSM V. It used to be thought that PTSD only occurred in combat situations but it is now known that it can occur […]
“My child can’t focus. What does that mean?”
Many children and adolescents present to their primary care provider’s office with concerns about inattention, poor focus or poor concentration. Since the primary care provider’s office is typically the first stop, it is important to be comfortable further evaluating the presenting problem, identifying associated symptoms, determining the diagnosis and implementing the best treatment plan. Many […]
10 Strategies for Improving Medication Adherence
Inconsistent adherence to psychotropic medication is a common problem in the primary care setting and a frustration for treatment providers. Studies show that 3 months after initiating treatment for MDD, only 50% of patients are adherent to the prescribed medication. Adherence rates for patients with schizophrenia are 50-60% and for patients with bipolar disorder can […]
OCD
It used to be thought that obsessive-compulsive disorder (OCD) was rare, but it is more common than originally thought. The prevalence is between 2-3% worldwide and it affects males and females equally. Symptoms usually present between childhood and early adulthood, with 75% of patients having symptoms before the age of 18. OCD can be a […]