Weekly Newsletters


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    Positive Mental Health: A Better Outcome Measure For Remission? 6/15/2022

    Symptom remission has been traditionally used as the desired outcome measure for remission in mental health disorders clinical trials.   This is not however what patients actually perceive as remission or what they want from treatment? When this contrast has been assessed, patients indicate that what they are looking for with remission is a return to […]

    Impacting Social Determinants of Health in Primary Care 5/26/22

    Approaches to Impact Social Determinants of Health: V & Z Code Awareness From the macro level of statistical data, we can readily demonstrate and appreciate that larger forces are at play in determining the health and welfare of groups and individuals, but translating that understanding about the Social and Environmental Determinants of Health down to […]

    Refugees & Migrants Face Major Mental Health Challenges 4/27/2022

    San Diego County is home to many refugees and migrants and the current crisis highlights the longstanding crisis of migration that is driven by multiple factors.  According to the California Department of Social Services, between the year of 1975 to 2017, 86,598 refugees came to San Diego County. The rate of arrival has increased in […]

    The Columbia Suicide Severity Rating Scale— Clinical Implications 4/13/22

    As a public health concerns, suicide is a serious issue.      It is the 12th leading cause of death accounting for the loss of nearly 46,000 Americans in 2020, occurring at a rate of 130 per day.  There an estimated 1.2 million suicide attempts made in 2020.  Overall male to female ratio for suicides is roughly […]

    Depression in Adolescents 3/30/2022

    The prevalence of Major Depression Disorder (MDD) in adolescents is 6%, with an additional 5-10% of teens presenting with sub-syndromal symptoms of depression. There is a 2:1 female: male ratio for MDD in adolescents. Teens frequently don’t necessarily present with the typical DSM criteria for MDD. Common depressive symptoms in adolescents include: irritability (as opposed […]

    ADHD in the Primary Care Setting 3/16/2022

    Attention-Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that can impact children’s lives in many ways. Unidentified and untreated ADHD can cause difficulties at school, at home and can contribute to anxiety and mood symptoms. In 2019, The American Academy of Pediatrics published updated clinical guidelines for the diagnosis, and management of ADHD, recommended ADHD evaluation […]

    PMDD-Premenstrual Dysphoric Disorder 3/2/2022

    Approximately 75% of women experience premenstrual changes – with increased irritability, tension, depressed mood, breast tenderness and bloating – commonly referred to as premenstrual syndrome (PMS). A small proportion (5-10%) of women experience significantly more disruptive psychological symptoms that can range from moderate to severe intensity that is recognized as Premenstrual Dysphoric Disorder (PMDD).  Individuals […]

    Magical Thinking 2/16/2022

    Humans are uniquely gifted with the extraordinary capability to think rationally and objectively, and we typically perceive ourselves as functioning as logical, reasoned and objective beings.  In this perception, we are probably not thinking with full clarity, as we all have moments where emotions and other factors get in the way.  More fundamentally, our cognition […]

    Adolescence:  Danger or Opportunity?    In truth, a bit of both. 2/2/2022

    The past several years of pandemic and of social and political unrest have, of course, been uniquely challenging for teens (and their families), adding a layer of complexity that has compounded an already challenging phase of life.  During recent times, greater levels of anxiety and depression have been evident in lots of teens and there […]

    Recognizing and Responding to Psychotic Disorders in Pediatric Primary Care: Part 2

    Our last newsletter introduced the issue of recognizing and responding to psychotic symptomatology in primary care pediatrics and noted the potential pivotal role that early recognition plays in offering opportunity to refer for treatment, in both the short term and with an eye to the potential lifelong consequences for afflicted individuals.   Today’s focus will provide […]