Sleep Apnea and Psychiatric Illness 1/17/2019

There is an interesting relationship between obstructive sleep apnea (OSA) and psychiatric disorders, particularly major depressive disorder (MDD). Given that both are commonly seen in the primary care setting, it is important for providers to understand that relationship in more detail. OSA can play a role in exacerbating medical problems in people with mental health […]

Perinatal Depression 1/10/2019

The American Academy of Pediatrics released an updated policy statement urging physicians to increase screening of women for perinatal depression. The statement titled “Incorporating Recognition and Management of Perinatal Depression into Pediatric Practice” was updated from an original statement in 2010. Perinatal depression can affect women during pregnancy and up to one year after delivery. […]

Treatment Resistant OCD

In a previous e-weekly, we discussed assessment and treatment of obsessive-compulsive disorder (OCD). It is well known that OCD is a chronic waxing and waning disorder. The hidden nature of symptoms and the reinforcement provided by the reduction in anxiety after performing a compulsion contribute to sustained illness. Once the diagnosis of OCD is made, […]

What happens first—depression or chronic illness? 12/20/2018

Both mental health disorders and chronic diseases are common and disabling. These conditions can affect anyone, regardless of age, culture, race/ethnicity, gender, or income. The cause is not entirely clear, but it is believed to be a combination of changes in the brain and other neurobiochemical reactions, lack of functionality, and medication related side effects. […]

Treating Neuropsychiatric Symptoms related to Dementia 12/13/2018

More than 5 million older adults in the United States are living with Alzheimer’s disease and other dementias. Although dementia is viewed as a memory loss disorder, neuropsychiatric symptoms (NPS) are common features. NPS can include aggression, agitation, wandering, depression, anxiety, sleep disturbance and paranoia. Nearly all patients with dementia will develop at least one […]

Mental Health Concerns in Adults with Autism Spectrum Disorders 12/6/2018

As the Autism Spectrum Disorders (ASD) are being better recognized and identified, both in early childhood and even in later childhood and adolescence, this is leading to better awareness of the impact of autism on some of our adult patients. As we know, ASD is a lifetime condition. Patients with ASD are at higher risk […]

Impact of Excessive Screen Time in Children 11/29/2018

With the increased use of technology in our everyday lives, it is not surprising that children and adolescents are using screens at higher rates than ever before. Parents estimate that children ages 2-8 spend about 2 hours per day on digital devices, children ages 8-12 spend about 4.5 hours per day on screens and teenagers […]

How to Manage School Refusal 11/15/2018

Families often present to their primary care providers when their children are refusing to go to school. School refusal can happen for a variety of reasons. Some school refusal may be time-limited, but most children who are refusing to go to school on an extended basis have an underlying psychiatric concern such as major depression, […]

Important Drug Interactions with the SSRIs 11/8/2018

Selective serotonin reuptake inhibitors (SSRIs) are commonly used psychotropic medications to treat depression and anxiety. It is important to be aware of common drug interactions between them and other medications, especially because some SSRIs are competitive inhibitors of a variety of cytochrome P450 liver enzymes. Therefore, they can dramatically increase the blood levels of medications […]

Screening for Suicide Risk Among Teens 11/1/2018

Suicide is now the second leading cause of death in adolescents, in the United States, surpassing homicide and second only behind unintentional injuries (motor vehicle accidents, accidental overdose). This switch occurred because of both a reduction in deaths from homicide and a modest increase in deaths from suicide. Deaths from suicide had been decreasing from […]