Definition and Overview

Neuropsychiatry follow-up is an appointment with a specialist who has an extensive background in both neurology and psychiatry (such as a behavioral neurologist) following the completion of the previously prescribed treatment.

Neuropsychiatry is a broad and complex scientific field that deals with two disciplines: neurology, which relates to the nervous system particularly the brain, and psychiatry, the medical specialty that delves with mental disorders. Neuropsychiatry is considered a subspecialty of psychiatry, and specialists in this field have advanced knowledge on higher brain functions such as the cerebral cortex system.

Neuropsychiatry deals with the understanding and management of behavior in relation to neurological conditions. Simply put, it aims to analyse, predict, determine, treat and manage different behavioral changes that may occur in a person with a mental disorder that is commonly rooted in a specific neurological condition like epilepsy, stroke, or traumatic brain injury. For this reason, neuropsychiatry is also referred to as behavioral neurology.

As an example, a 2008 study showed that at least 30% of stroke patients develop depression either soon or a few months after their illness. Depression can potentially reduce the quality of life of the patient and even lead to self-harm and death. Neuropsychiatry is useful in exploring this under-diagnosed impact of the neurological condition so appropriate intervention can be implemented.

Who Should Undergo and Expected Results

Neuropsychiatry follow-up may be performed on patients who have undergone some type of treatment or therapy to address behavioral changes caused by a certain neurological condition. However, it is important to note that not all individuals who have experienced a brain-related injury or disease go through neuropsychiatry treatment for the simple reason that certain behavioral manifestations do not exist or appear. However, if they do, patients may undergo different kinds of intervention, including but not limited to medications, counseling, cognitive behavioral therapy, or psychotherapy.

The purpose of the follow-up is to check whether these treatments have worked or whether a new treatment needs to be planned, taking into consideration areas that have to be modified. If the patient is under medication, the follow-up can help determine whether it can already be stopped, a new medication needs to be recommended, or the dosage has to be changed (e.g. increased or decreased). The neuropsychiatrist can also monitor the health effects of these drugs to both the behavior and condition of the patient.

During the follow-up, the neuropsychiatrist can also evaluate symptoms and identify if they have worsened or new issues are about to occur. At this point, the follow-up becomes a tool to manage or prevent future problems that can only further decrease the patient’s quality of life.

How Does the Procedure Work?

Follow-up care is an integral part of the treatment plan of a neuropsychiatry patient. But before it happens, the patient goes through an engagement period, where he participates in different behavioral interventions suggested by the neuropsychiatrist.

After that, the neuropsychiatrist will inform the patient about the succeeding follow-up. The number or frequency of follow-up sessions depends on many factors, including the age, improvement, overall health condition and participation of the patient. It may range from one to several follow-up visits spanning for a few weeks to a couple of months or even years such as in the case of progressive disorders like Alzheimer’s or Parkinson’s diseases.

During the follow-up, the neuropsychiatrist will:

  • Review the outcomes and recommendations made in the previous follow-up
  • Conduct different tests to evaluate the expected outcomes and recommendations
  • Communicate with the patient to know if there are any changes to the neurological condition, behavior, or both
  • Suggest medical interventions if necessary (for example, stroke patients with speech impediments may be referred to a speech pathologist)
  • Coordinate with other members of the health care team like therapist, neurologist, or physical therapist
  • Provide guidelines on how to improve the patient’s coping skills according to the limits of the knowledge and expertise of the neuropsychiatrist

Possible Risks and Complications

The field of neuropsychiatry is complex that it is difficult to find a specialist who can perform the consultation, more so a follow-up. Further, the follow-up care may fail for a variety of reasons, including poor or miscommunication. Implementing technologies such as medical records software that can automatically send out follow-up schedule notifications by phone can potentially enhance the process.

Reference:

  • American Neuropsychiatric Association
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