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Trauma as a determinant of health
What changed our practice was a fundamental recognition of trauma as a determinant of health, and furthermore, that PTSD is only the tip of the iceberg when it comes to trauma. Much lies under the surface for our patients.
Long-term benzodiazepine use is associated with increased mortality in people with schizophrenia
When psychiatric patients are treated in an emergency department, they are often hypervigilant, manic, or otherwise in an excited, agitated state. The current standard of care to manage acute agitation in adults is using an antipsychotic medication and a benzodiazepine, often loxapine or haloperidol and lorazepam.
Diagnosing processing disorders
As a general pediatrician, I see many children whose behaviour and/or development is not emerging as expected. A diagnosis such as autism or learning disability may be the obvious explanation; but frequently it is not so straightforward. Parents come armed with questions about ‘processing disorders’ and and they expect their MD to be knowledgeable.
Concussion rehabilitation
The statistics regarding recovery from concussion indicate that the majority of individuals will be symptom-free at 3 months; within 6 months 70-75% will be symptom free; and within a year 10% will have 1 persisting symptom and 5% will have 4 or more persisting symptoms
This app changed my practice – Treatable Intellectual Disability Endeavor in B.C. (TIDE) – Treatable ID App www.treatable-id.org
Affecting 2-3% of Canadians, intellectual disability (ID) is a lifelong, devastating condition defined by deficits in cognitive functioning (IQ<70) and adaptive skills. It is called global developmental disability (GDD) in children less than 5 years of age; it is defined as deficits in 2 or more developmental domains. In Canada, approximately 7,600-11,500 children are born annually with GDD. Identification of GDD or ID in children is the essential first step and often a task for the primary care practitioner.
Measurement of depressive symptoms improves outcomes in primary care
Simple use of a self-rated symptom checklist can double the odds of response to antidepressant medication in primary-care patients.
This app changed my practice: Mindshift App
Mental health problems including anxiety, depression and stress make up a large proportion of a typical day in primary care medicine. They also contribute a huge comorbid burden in specialty care. These conditions all require an intense amount of time to help and manage patients.
Non-suicidal self-injury
Often, self-injury is managed and treated in the context of therapy work with a psychologist or psychiatrist. Family physicians, however, are in an excellent position to be first responders, to offer helpful suggestions, and to help refer the patient to appropriate care.
Early diagnosis of autism
Autism rare? Not so now. The current prevalence is a staggering 1 in 68, about four times as common as type 1 diabetes, with a male to female ratio of 5:1.
Depression in the elderly
Depression can have devastating effects on the elderly and their families. Moreover, it is often under recognized, as it can present atypically, with agitation/ anxiety, somatic symptoms, or cognitive and functional decline rather than sadness and withdrawal.
Self-management of mood problems
Innovative forms of service delivery have the potential to greatly expand the scope of depression intervention. Series of self-management workbooks designed to teach depressed individuals evidence-based skills for mood management, available for free download from http://www.comh.ca/selfcare/.
Monitoring of cardiovascular disease risk in people with chronic mental illness
The evidence has become impossible to ignore that people with chronic mental illness are dying from heart attacks and strokes at a higher rate than the general population.
The natural history of severe dementia
In providing care to frail and severely demented elderly we see many patients with aspiration pneumonia, swallowing problems and failing to eat. We also see many patients fail to get better even when we have adequately addressed their acute medical issues.
New fee codes and treatment options have improved my care of patients with mental health problems
It was usually difficult to get my patients into appropriate resources and due to my lack of tools and time to help these patients, I would often prescribe medications.
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