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» This Changed My Practice » Mental Health

Mental Health

"Autism Awareness Ribbon" by White_ribbon.svg: MesserWolandJigsaw_Puzzle.svg: Psyonderivative work: Melesse (talk) - White_ribbon.svgJigsaw_Puzzle.svg. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Autism_Awareness_Ribbon.png#mediaviewer/File:Autism_Awareness_Ribbon.png

“Girls on the Spectrum”: Autistic Spectrum Disorder in Girls

By Dr. Alisa Lipson on September 25, 2019

Now in 2019, we are learning that the incidence in girls is higher than previously thought. The girls are catching up to the boys. What is that about? Turns out that the girls are better at hiding their disability but it is there. So, we have to look harder.

Read More | 5 Comments

mental-health

ACEs (Adverse Childhood Experiences): One Family Physician’s Experience

By Dr. Tahmeena Ali on August 21, 2019

I now ask all patients, young and old, new to my practice and established for years, male and female, to complete an ACEs questionnaire in my clinic. I garner a new level of respect for my patients’ resilience and for the ongoing turmoil many of my young patients face. I make finding supports for these young vulnerable patients one of my top priorities—as important as a referral to a specialist or for diagnostic imaging.

Read More | 9 Comments

The myth of the “Manipulative Personality Disorder”:  taking the blame out of the illness

The myth of the “Manipulative Personality Disorder”: taking the blame out of the illness

By Dr. Joanna Cheek on May 8, 2019

View personality disorder symptoms as important treatment targets in themselves. Be curious about each patient’s story, validate PD symptoms as coping mechanisms, focus on collaborative problem solving, set proactive regular visits, and also be mindful of your own emotional reactions providing compassion and empathy while setting clear boundaries.

Read More | 6 Comments

Parkinson’s disease: burden of non-motor problems

Parkinson’s disease: burden of non-motor problems

By Dr. Darly Wile on April 3, 2019

What I have found is that while it can sometimes be assumed that motor problems are the patient’s “biggest problem”, this is often not the case; instead, I now make a point of asking the patient, and their family directly: “What is the biggest problem for you right now?”

Read More | 3 Comments

Pregnant woman crying

Anxiety disorders among pregnant and postpartum women

By Nichole Fairbrother on March 20, 2019

Unwanted, intrusive thoughts of accidental harm to one’s infant are reported by 100% of new mothers, and unwanted, intrusive thoughts of intentionally harming one’s infant are reported by 50% of new mothers. Ask specifically about unwanted, intrusive thoughts of infant-related harm. Educate pregnant women and normalize the occurrence of the thoughts. Reassure women that, in the absence of any additional risk factors for child abuse, disclosure of these thoughts will not result in any action on the part of the care provider/physician.

Read More | 1 Comment

Fatigue

Trauma as a determinant of health

By Dr. Vanessa Brcic and Dr. Devon Christie on April 18, 2018

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.

Read More | 2 Comments

Long-term benzodiazepine use is associated with increased mortality in people with schizophrenia

Long-term benzodiazepine use is associated with increased mortality in people with schizophrenia

By Dr. Randall White on May 10, 2017

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.

Read More | 3 Comments

father comforting his crying little son - parenthood concept

Diagnosing processing disorders

By Dr. Alisa Lipson on September 28, 2016

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.

Read More | 8 Comments

Concussion rehabilitation

Concussion rehabilitation

By Sue Barlow, OT and Jennifer Loffree, OT on December 2, 2015

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

Read More | 3 Comments

http://www.treatable-id.org/

This app changed my practice – Treatable Intellectual Disability Endeavor in B.C. (TIDE) – Treatable ID App www.treatable-id.org

By Dr. Clara van Karnebeek and Dr. Sylvia Stockler on July 29, 2015

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.

Read More | No Comments

Measurement of depressive symptoms improves outcomes in primary care

Measurement of depressive symptoms improves outcomes in primary care

By Dr. Randall White on July 8, 2015

Simple use of a self-rated symptom checklist can double the odds of response to antidepressant medication in primary-care patients.

Read More | 6 Comments

Mindshift

This app changed my practice: Mindshift App

By Dr. Daniel Dodek on March 18, 2015

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.

Read More | 7 Comments

mental-health

Non-suicidal self-injury

By Dr. Alexander Chapman on January 6, 2015

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.

Read More | 2 Comments

"Autism Awareness Ribbon" by White_ribbon.svg: MesserWolandJigsaw_Puzzle.svg: Psyonderivative work: Melesse (talk) - White_ribbon.svgJigsaw_Puzzle.svg. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Autism_Awareness_Ribbon.png#mediaviewer/File:Autism_Awareness_Ribbon.png

Early diagnosis of autism

By Dr. Alisa Lipson on September 30, 2014

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.

Read More | 8 Comments

Depression in the elderly

Depression in the elderly

By Dr. Maria Chung on September 10, 2012

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.

Read More | 10 Comments

mental-health

Self-management of mood problems

By Dr. Dan Bilsker on April 11, 2011

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/.

Read More | 10 Comments

Advance care plan (ACP) for patients with multiple co-morbidities

Monitoring of cardiovascular disease risk in people with chronic mental illness

By Dr. Randall White on January 17, 2011

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.

Read More | 3 Comments

The natural history of severe dementia

By Dr. Amanda Hill on August 23, 2010

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.

Read More | 6 Comments

New fee codes and treatment options have improved my care of patients with mental health problems

By Dr. Bob Bluman on July 11, 2010

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.

Read More | 4 Comments

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      • Smoking Cessation
      • Transient Ischemic Attacks: High Risk and Treatable
      • Use of HAART as a strategy to stop HIV and AIDS
      • Early prenatal screening
      • Leaving warfarin for the rats? A new option in anticoagulation for atrial fibrillation
      • Minimizing radiation exposure – decision to order imaging?
      • An Update: BPH Management for Family Physicians
      • The Intra-Uterine Device
      • Pediatric allergy
      • The natural history of severe dementia
      • Understanding eGFR in the clinical context: who does and does not need referral?
      • Probiotic therapy has changed my approach to treating patients with irritable bowel syndrome
      • New fee codes and treatment options have improved my care of patients with mental health problems
      • Evidence shows that chemotherapy holidays may not be in the best interest for patients with metastatic colorectal carcinoma
      • New study on the use of erythropoietin stimulating agents in chronic kidney disease has made us evaluate the risk-benefit of ESA’s in CKD patients not on dialysis.
      • Choosing antihypertensive combos: does it matter how you do it?
      • MRSA skin and soft tissue infections
      • What are the CV risks of TZDs: have the safety questions been answered?

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