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Practice Guidelines for Treating AUD 4/18/2019

Alcohol Use Disorder (AUD) is very common and can lead to medical, occupational, social and legal impairments for affected individuals and their families. Despite the high prevalence of AUD and its significant public health consequences, patients with this disorder continue to be under-identified and undertreated. The American Psychiatric Association has recently come out with practice […]

Antidepressants for Chronic Pain 4/11/2019

It is not uncommon for a patient with depression to also suffer from chronic pain. Some antidepressants are known to be helpful for depression and anxiety disorders as well as some chronic pain conditions. They have been shown to be helpful in pain states that are a result of neural sensitization rather than somatic or […]

Talking with Teens About Pot 4/4/2019

There is a complexity when it comes to cannabis – it can be safe and benign, it can have medicinal components, and it can be harmful and dangerous. These are all true. As regulations around cannabis continue to loosen, it is imperative that providers understand that cannabis use will probably increase. It is therefore important […]

Treatment of Co-morbid Insomnia in Patients with Psychiatric Disorders 3/28/2019

30-50% of adults report transient concerns with insomnia and about 5-10% of adults have chronic problems with insomnia. Insomnia is defined as a subjective difficulty with initiating or maintaining sleep that results in daytime impairment. It can occur as a primary disorder or as a secondary disorder related to another medical condition, medication side effect, […]

How Anxiety Can Lead to Disruptive Behavior 3/21/2019

It is common for children and families to present to their primary care providers with concerns about behavioral problems and/or wanting to rule out ADHD. The typical presenting problem is severe temper tantrums or disruptive behavior in school. In some of these cases, the appropriate diagnosis is ADHD or another disruptive behavior disorder and treatment […]

Behavioral Management of Migraines 3/14/2019

While migraines are a medical and not a psychological condition, it is well known that psychological factors can impact a patient’s experience with migraines. It is widely known that migraines can be triggered by psychological stressors. Factors such as work stress, home stress, relationship difficulties, anxiety, depression and other issues can trigger headaches, maintain them, […]

“My Patient is Hearing Voices. What do I do?” 3/7/2019

Case Study: Patient Presenting with Mood and Psychotic Symptoms This article is based on a recent SmartCare consultation with a primary care provider. Case: 36 yo male who is a new patient presents with depressive symptoms since age 14 and previous suicide attempt at age 18. Additionally, he reports voices telling him negative things about […]

Understanding Different Assessments 2/28/2019

Patients will frequently present in the primary care setting asking for an assessment for a mental health or behavioral concern. It can be confusing to know which direction to send a family in and/or what type of assessment to refer for. There are some clarifying questions that a primary care provider can ask to better […]

“High Functioning” Depression 2/21/2019

There are people who have significant symptoms of depression but seem to have an unimpaired level of functioning. Their struggle is more internal and not readily apparent externally. This is sometimes referred to as “high functioning” depression or persistent depressive disorder (PDD) in the DSM V. PDD was referred to dysthymic disorder in the DSM […]

Helping Parents Understand Why Spanking is not Effective 2/14/2019

While the rate of corporal punishment is lessening over time, many parents continue to use spanking as a discipline tool. There is growing evidence on its limited efficacy and harmful effects. Parents often look to their children’s primary care providers for guidance on discipline. In fact, parents trust their doctors’ recommendations on parenting as much […]