Mental Health

Offering CBT skills by group medical visits

By Drs. Fiona Petigara and Joanna Cheek on September 28, 2022

Authors Fiona Petigara, MD, CCFP (biography, no disclosures) Joanna Cheek, MD, FRCPC (biography and disclosures) Disclosures: Received funding from Shared Care: sessional funding to develop and spread CBT Skills Group Program. Mitigating potential bias: Recommendations are consistent with published guidelines (e.g. CANMAT depression and anxiety guidelines) and current practice patterns. What I did before Fiona […]

Physician well-being during COVID-19 — burnout & moral injury

By Beata Chami on October 5, 2021

It has been eighteen months since COVID-19 emerged in Canada. The trajectory of the pandemic has placed a strain on our citizens’ mental health, particularly our frontline workers. While physician well-being has been a longstanding concern, the global pandemic has magnified the daily challenges that clinicians so bravely navigate to safeguard the health of their patients.

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 3: The Importance of Attachment Theory in Healthcare

By Dr. Linda Uyeda and Dr. Ashley Miller on July 7, 2021

The ingredients needed to create a happy workplace also largely reflect the principles of secure attachment. Across all levels within organizations, if people do not feel “safe, seen, soothed, and secure” they are more likely to make errors, breach safety protocols, and struggle working together as a team.

Concussion rehabilitation update and a free self-management concussion tool

By Sue Barlow and Carolyn Rondeau on June 3, 2021

Concussions or mild traumatic brain injury are the most common type of traumatic brain injury. It is estimated that every year in British Columbia (BC), there are approximately 14,500 visits to the emergency department and that this number is most likely an underestimate of the “true burden of concussion”.

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father comforting his crying little son - parenthood concept

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 2: Parenting During a Pandemic

By Dr. Ashley Miller and Dr. Linda Uyeda on May 12, 2021

As I started to understand that this pandemic would wear on, I had to figure out how to help my patients’ families and my own family navigate our way through this totally new reality. I drew on the science of attachment, resilience and healthy relationships to make a plan. (Please stay tuned for Article #3!)

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 1: Cultivating secure bonds with our children during stressful times

By Dr. Linda Uyeda and Dr. Ashley Miller on March 3, 2021

(Please stay tuned for Article #2: ‘Parenting during a pandemic’. We will expand on how to nurture these secure attachments with our children.) By Dr. Linda Uyeda (biography and disclosures) and Dr. Ashley Miller (biography and disclosures) (Members of the Child and Youth Mental Health and Substance Use Community of Practice and the Working Group […]

Practice tip: medication-induced stuttering in psychiatric patients

By Dr. Mary V. Seeman on February 5, 2020

Fellow psychiatrists often ask whether their patients with schizophrenia are aging prematurely. They point to the fact that several of their patients seem slowed down, forgetful, fidgety, and that they garble their words and stutter. These are, of course, all side effects of antipsychotic medication.

“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.

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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.

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.

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?”

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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.

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.

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.

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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.

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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

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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.

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.

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.

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.

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"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.

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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.

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/.

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.

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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.

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.

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Mental Health

Offering CBT skills by group medical visits

Physician well-being during COVID-19 — burnout & moral injury

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 3: The Importance of Attachment Theory in Healthcare

Concussion rehabilitation update and a free self-management concussion tool

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 2: Parenting During a Pandemic

Curing Through Connection: A 3-part series on attachment, resilience, and health. Article 1: Cultivating secure bonds with our children during stressful times

Practice tip: medication-induced stuttering in psychiatric patients

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

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

Parkinson’s disease: burden of non-motor problems

Anxiety disorders among pregnant and postpartum women

Trauma as a determinant of health

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

Diagnosing processing disorders

Concussion rehabilitation

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

Measurement of depressive symptoms improves outcomes in primary care

This app changed my practice: Mindshift App

Non-suicidal self-injury

Early diagnosis of autism

Depression in the elderly

Self-management of mood problems

Monitoring of cardiovascular disease risk in people with chronic mental illness

The natural history of severe dementia

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

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