SMARTer CARE Newsletters
Sign up for our weekly SMARTer Care newsletter! Receive articles of interest with a wide variety of subjects associated with psychiatry and the practice of primary care medicine. Just add your email address below or email BHCS.provider@vistahill.org.
Planning for a Positive Summer 6/11/25
It’s officially summertime! While summer often brings excitement for beach days and family vacations, it can also stir up more complicated emotions. Some youths may dread the social isolation or heightened family tensions that can accompany the season. For caregivers, the sudden increase in unstructured time and financial strain can feel overwhelming. However, with thoughtful […]
Caffeine Consumption in Individuals with Mental Health Disorders: Clinical Benefits and Risks 5/28/25
Caffeine, a central nervous system stimulant consumed by approximately 85% of adults in the United States daily, has complex implications for individuals with mental health disorders. Its primary mechanism involves non-selective antagonism of adenosine A1 and A2A receptors, resulting in increased dopamine and norepinephrine transmission—neurotransmitters implicated in multiple psychiatric conditions. While moderate caffeine intake may […]
Culturally Adapted Family Therapies for American Indian and Alaska Native Youth: Integrating Tradition and Evidence-Based Practice 5/14/25
Many of the evidence-based therapies that healthcare providers use to treat youth emotional and behavioral concerns arise from literature in which under-represented communities were not included in the population sample. Therefore, a theoretical question arises in whether or not such therapies are indeed evidence based and/or applicable to under-represented minority communities. Moreover, it is possible […]
Management of Antipsychotic-Induced Weight Gain 4/30/25
As discussed in a previous newsletter, psychotropic medications, particularly antipsychotics, can lead to clinically significant weight gain. Second-generation antipsychotics, such as olanzapine and clozapine, are believed to disrupt glucose, lipid, and appetite regulation by acting on dopamine, serotonin, histamine, and muscarinic receptors. These medications also influence hormones such as leptin, adiponectin, and ghrelin, promoting increased […]
Psychotropic Drug-Related Weight Gain 4/16/25
Weight gain is a common and often concerning side effect of psychotropic medications, including antidepressants, antipsychotics, lithium, and anticonvulsants. A systematic review by Sepulvida-Lizcano et al. found that 89% of frequently prescribed psychotropic medications are associated with metabolic alterations. This is particularly concerning for children and adolescents, who are at heightened risk of weight gain […]
NEXT STEPS WHEN THERE IS A CONCERN FOR AUTISM 4/2/25
Given the increasing prevalence of autism, currently 1 in 36 children, and the awareness of the importance of early intervention, it is vital that we as providers guide families appropriately when this concern is brought up. In the primary care setting this often starts with a screening tool based on the child’s age. For older […]
How Anxiety Can Present as Disruptive Behavior 3/19/25
It is common for children and families to present to their primary care providers with concerns about externalizing behavioral problems and/or wanting to rule out Attention Deficit Hyperactivity Disorder (ADHD) or another disruptive behavioral disorder. A common presenting problem is severe outbursts at home and/or disruptive behavior in school. In some of these cases, the […]
Differentiating Pediatric Bipolar Disorder, Attention-Deficit/Hyperactivity Disorder, and Disruptive Mood Dysregulation Disorder: A Clinical Perspective 3/5/25
The differentiation of pediatric bipolar disorder (PBD), attention-deficit/hyperactivity disorder (ADHD), and disruptive mood dysregulation disorder (DMDD) remains a significant challenge for mental health professionals due to overlapping symptomatology. These disorders manifest in affective and behavioral dysregulation, yet they have distinct pathophysiologies, developmental trajectories, and treatment implications. This article provides an in-depth analysis of these disorders […]
Why Isn’t My Patient/Client Showing Up? Best Practices for Irregular or No-Show Visits in Mental Health Clinical Settings 2/19/25
Client no-shows and irregular appointment attendance can be a significant challenge for mental health providers, impacting both clinical outcomes and practice management. While occasional missed appointments are expected, consistent no-shows can indicate deeper issues that require careful consideration. This article outlines best practices for addressing client no-shows in a manner that supports the client while […]
The Cardiovascular Risks of Stimulants 2/5/25
Stimulants, including methylphenidate and amphetamine salts, are considered the first-line treatment in most cases of attention-deficit/hyperactivity disorder (ADHD). The diagnosis of ADHD and the use of stimulants in both youth and adults have risen over recent decades. Approximately 6.1 million children and adolescents in the United States are currently on stimulants. Both the American Academy […]