Definition & Overview

Neuropsychiatry is a specialised branch in the field of medical and clinical sciences that combines the disciplines of neurology (the study and treatment of disorders of the nervous system) and psychiatry (the study and treatment of mental disorders). As such, neuropsychiatry is mainly concerned with issues in higher brain function, such as those related to cognition, emotion and behavior, that cause abnormal or psychiatric problems, and behavioral difficulties that are linked or caused by various neurological conditions.

Neuropsychiatry (where psychiatric conditions have an effect on behavioral problems) and behavioral neurology (where behavioral problems are caused by psychiatric conditions) are two terms that are now used interchangeably as they have been merged into one because of their similar and overlapping disciplines. Those who specialize in both medical professions (neurology and psychiatry) are either called neuropsychiatrists or behavioral neurologists. These are the doctors to visit for a neuropsychiatry consultation.

A neuropsychiatry consultation is initiated by a referral from a neurologist, psychiatrist or neuropsychologist (those with PhDs in psychology). It usually involves a series of tests and evaluations that can take a couple of days, depending on the patient’s medical history and test results. Once the results are in, a diagnosis is made and a treatment program is designed. Occasionally, the patients may be referred back to the attending physician, but there are times when the treatment is accomplished and monitored by the neuropsychiatrist and his team.

Who Should Undergo and Expected Results

Neuropsychiatry or behavioral neurology encompasses a wide range of medical and clinical conditions. Patients who suffer from the following can benefit from a neuropsychiatry consultation:

  • Cognitive problems - Memory impairment, inattentiveness, distractibility, difficulty in problem solving and loss of self-monitoring skills

  • Behavior or mood problems – such as depression, anger, inappropriate behavior, apathy, mania and bipolar disorder

  • Cognitive, behavioral problems and psychosis stemming from illnesses and diseases like brain tumors, lupus, epilepsy, traumatic brain injury, autism and post-traumatic stress disorder (PTSD)

  • Seizures that are accompanied by behavioral, emotional or cognitive difficulties

  • Sleep disorders such as narcolepsy, insomnia and sleep apnea that are associated with neurological conditions

  • Eating disorders such as (bulimia nervosa) or eating too little and (anorexia nervosa) that stem from anxiety and depression

  • Degenerative diseases like dementia, Parkinson’s and Alzheimer’s that affect a patient’s memory capabilities and often manifest in periods of forgetfulness and disorientation

How Does the Procedure Work

The goal of a neuropsychiatry consultation is to evaluate patients and diagnose their condition. Upon further testing, neuropsychiatrists or behavioral neurologists can recommend either a short-term or long-term treatment plan, depending on each patient’s case. Every consultation is different but may be administered in a similar fashion by following the steps below:

  • Most neuropsychiatry consultations begin with a referral. The patient is referred by his neurologist or neurosurgeon to a neuropsychiatrist or behavioral neurologist. The former’s clinic will then forward the patient’s information and medical history to the latter’s clinic and together, they will arrange for an appointment for the patient.

  • Usually, the patient has to fill out a health questionnaire detailing his previous and current medical history and try to complete the symptom checklists and rating scales. Family members and caregivers are also invited to submit their own opinions.

  • At the clinic, the doctor will obtain the patient’s vital signs and this is typically followed by a thorough physical examination.

  • A comprehensive neurological examination, psychiatric interview and a test that will determine the patient’s mental status will be performed by a psychiatrist or neuropsychiatrist.

  • An exhaustive series of psychological and neurocognitive tests will then begin. The tests will evaluate the patient’s feelings, his personality and patterns of thought. The tests will also measure his attention span, memory function, logical thinking, reaction time and others.

  • The discussion between a neuropsychiatrist and patient covers a lot of ground and family members and caregivers are encouraged to participate in the discussion.

  • In the event that initial results are inconclusive, additional tests may be performed.

  • Once the doctor has finalised his diagnosis, he will recommend a treatment program for the patient. He may refer the patient back to the referring physician or the clinic will handle the treatment program. In some cases, patients are referred to a different specialist depending on the nature of the condition.

Possible Complications and Risks

A neuropsychiatry consultation is a non-invasive procedure but it may be exhaustive depending on the number of tests and the hours of evaluation. It may be difficult for some patients and this may affect the results especially when the patient becomes disturbed, stressed or tired during the process.

References:

  • The International Neuropsychiatric Association
  • The Centre for Neuropsychiatry
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