Sleep Problems for Youth with Autism: Common, Treatable, At Times Challenging 7/6/22

Sleep disturbances are common among children and adolescents with Autism Spectrum Disorder (ASD). Up to 80% of parents in one review of youth with ASD reported prolonged sleep disturbances (Malow et al., 2016).  Many studies have explored epidemiology, phenomenology and treatment strategies for insomnia in children with ASD or other neurodevelopmental or psychiatric disorders. While […]

Positive Mental Health: A Better Outcome Measure For Remission? 6/15/2022

Symptom remission has been traditionally used as the desired outcome measure for remission in mental health disorders clinical trials.   This is not however what patients actually perceive as remission or what they want from treatment? When this contrast has been assessed, patients indicate that what they are looking for with remission is a return to […]

Impacting Social Determinants of Health in Primary Care 5/26/22

Approaches to Impact Social Determinants of Health: V & Z Code Awareness From the macro level of statistical data, we can readily demonstrate and appreciate that larger forces are at play in determining the health and welfare of groups and individuals, but translating that understanding about the Social and Environmental Determinants of Health down to […]

Refugees & Migrants Face Major Mental Health Challenges 4/27/2022

San Diego County is home to many refugees and migrants and the current crisis highlights the longstanding crisis of migration that is driven by multiple factors.  According to the California Department of Social Services, between the year of 1975 to 2017, 86,598 refugees came to San Diego County. The rate of arrival has increased in […]

Depression in Adolescents 3/30/2022

The prevalence of Major Depression Disorder (MDD) in adolescents is 6%, with an additional 5-10% of teens presenting with sub-syndromal symptoms of depression. There is a 2:1 female: male ratio for MDD in adolescents. Teens frequently don’t necessarily present with the typical DSM criteria for MDD. Common depressive symptoms in adolescents include: irritability (as opposed […]

ADHD in the Primary Care Setting 3/16/2022

Attention-Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that can impact children’s lives in many ways. Unidentified and untreated ADHD can cause difficulties at school, at home and can contribute to anxiety and mood symptoms. In 2019, The American Academy of Pediatrics published updated clinical guidelines for the diagnosis, and management of ADHD, recommended ADHD evaluation […]

PMDD-Premenstrual Dysphoric Disorder 3/2/2022

Approximately 75% of women experience premenstrual changes – with increased irritability, tension, depressed mood, breast tenderness and bloating – commonly referred to as premenstrual syndrome (PMS). A small proportion (5-10%) of women experience significantly more disruptive psychological symptoms that can range from moderate to severe intensity that is recognized as Premenstrual Dysphoric Disorder (PMDD).  Individuals […]

Magical Thinking 2/16/2022

Humans are uniquely gifted with the extraordinary capability to think rationally and objectively, and we typically perceive ourselves as functioning as logical, reasoned and objective beings.  In this perception, we are probably not thinking with full clarity, as we all have moments where emotions and other factors get in the way.  More fundamentally, our cognition […]

Adolescence:  Danger or Opportunity?    In truth, a bit of both. 2/2/2022

The past several years of pandemic and of social and political unrest have, of course, been uniquely challenging for teens (and their families), adding a layer of complexity that has compounded an already challenging phase of life.  During recent times, greater levels of anxiety and depression have been evident in lots of teens and there […]