Opioid Use Disorders: Assessment and Treatment 9/17/21

A person can be diagnosed as having an opioid use disorder if he or she develops symptoms of tolerance and withdrawal to opioids in association with various behavioral profiles, described below. Tolerance is defined as either needing a larger amount to achieve the same effect or having less effect from the same amount. Withdrawal is […]

Oppositional Defiant Disorder (ODD) 9/8/2021

Most children exhibit oppositional and defiant behavior at least some of the time.  Particularly in young and early latency age children, these behaviors are considered developmentally appropriate.   The key to considering a diagnosis of ODD is that the child’s behaviors have to be pervasive and occur across multiple settings and be present in a pervasive […]

Heading Back to School in the COVID-19 Pandemic 9/1/2021

Students nationwide are returning to school after over a year of virtual or hybrid learning. Most youth across San Diego were prompted to smile with their eyes for their memorable first day of school photos. Masks, hand-sanitizers, and distanced drop-offs are new additions to the school routine. Regular first day of school jitters about new […]

Late Onset ADHD  — when might it be for real?? 8/23/2021

Today’s article is a follow up to last week’s newsletter that address the patterns of persistence of ADHD symptomatology through late adolescence and into early adulthood.  The results of that study are strongly suggestive that ongoing monitoring is warranted for many of these individuals throughout their teen years and into their early adult years as […]

Residual ADHD Symptomatology Persisting into Adulthood 8/16/2021

A recent study published in the American Journal of Psychiatry presents data that suggests that up to 90% of children diagnosed as having attention-deficit/hyperactivity disorder (ADHD) may continue to experience intermittent residual symptoms of the disorder into young adulthood.  This finding runs counter to general clinical consensus that only one-third to one-half of youth persist […]

Discussing Their Futures with Kids in Primary Care 8/3/2021

Erik Erikson, Ph.D., a lay psychoanalyst, was a great thinker, skilled clinician, and compelling writer who viewed human psychology in a developmental context.  His schema describes nine major psychosocial developmental stages and the associated psychological challenges, from infancy to the end of life. Today’s newsletter discusses how a primary care provider, working within the time […]

Rules for a Healthier & Happier Family 7/19/2021

SmartCare is a San Diego County-funded program that works with families of all sorts: single-parent, divorced, married, unmarried, remarried, casually coupled, multigenerational, you name it. Parents call us for various reasons centered on their children’s needs, but they often share their concerns about their own and their family’s situation. SmartCare sees value in discussing family […]

SmartCare & the National Pediatric Mental Health Care Access Program 7/8/2021

As an early adopter and provider of child psychiatric consultation to the pediatric community, SmartCare Behavioral Healthcare Consultation Services (SmartCare BHCS) has worked with the local pediatric community for more than one decade.  In 2020, the program has served nearly 1600 children and families and provided 550 consultations to 298 distinct primary care pediatric providers.   […]

Prescribing for Foster Children:  PCPs & the JV-220 process 7/2/2021

Today’s e-Weekly provides an overview of the JV-220 process as it applies to a general pediatric primary care practice and provides references to relevant forms and protocols to assist in compliance with informed consent regulations for youth in foster care in San Diego County. Prescribing psychotropic medications to children and adolescents who are in foster […]

Elevated or Irritable Mood States: Mania & Hypomania 6/24/2021

A unique element in behavioral health care — that of assessing a patient’s abnormal mood states — may on occasion be a special concern in the primary care setting. Comfort with assessing mood states and making appropriate psycho-social and medical interventions can be important skills. This eWeekly discusses the issues of mania and hypomania, as […]