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Neuropsychiatric Assessment
Neuropsychiatric Assessment
Written by Ava Easton, Adult Support Coordinator with advice from Professor Anthony David, Institute of Psychiatry, London
A Neuropsychiatrist is a psychiatrist with expertise in the diagnosis and management of people who have psychiatric (including behavioural, emotional, and cognitive) complications following a neurological condition, such as encephalitis. S/he can also prescribe medication and arrange for other forms of support as needed.
Neuropsychiatrists are scarce and therefore you may be referred to a general psychiatrist. However, in order to be of most benefit to you it would be helpful if they have a ‘special interest’ in neuropsychiatry
Who should access a Neuropsychiatrist?
Any person who has developed emotional, psychiatric, or behavioural problems following an acquired brain injury.
The Aim of a Neuropsychiatric Assessment is to:
- Risk assess the situation in light of the person’s problems
- Identify and assess the presence of a psychiatric disorder, for example, anxiety,depression, psychosis etc.
- Identify and assess any acute or chronic cognitive impairment
- Identify the cause or reason for the person’s diffi culties.
A neuropsychiatrist will also try to identify whether there were any factors that predispose, precipitate or maintain the person’s difficulties. For example:
- Organic factors - amount, location and severity of brain damage; any psychiatric disorder
- Psychological factors - premorbid adjustment and a person’s insight and emotional responses
- Social factors - their support and any learned responses
A Neuropsychiatric Assessment will include:
- A History of the Illness and subsequent problems, by establishing the cause and the progress. The neuropsychiatrist will usually consult casenotes, the person and any close family and carers, in order to do this.
- A Background History by establishing the person’s past medical, psychiatric, personal and social history. The neuropsychiatrist will usually consult case notes, the person and any close family and carers in order to do this.
- An Assessment of the Person’s Mental State by considering the person’s emotions, perception, thought and cognitive processes. The Neuropsychiatrist may also conduct or ask the family or carers to conduct on-going behavioural observations.
- Any other special investigations which the neuropsychiatrist may consider necessary.
Management of a person’s problems may require one or more of the following interventions:
Risk Management of
- The person’s environment. For example their safety, containment, physical care needs and their quality of life
- Family, friends, carers or staff and any training needs they may have
- Any indications under the mental health act. For example if the person is at risk of harming themselves or others.
Behavioural Psychology Approaches
Treatment by psychotropic medication for psychiatric disorders
Treatment by medication in order to modify a person’s behaviour (This should be a last resort and should cause no harm to the person)
Liaison with the generic, local psychiatric services
It is important to remember that all medications have side effects, however there are a range of effective and safe treatments available to treat many types of psychiatric problem, such as depression, mood swings and aggression
Neuropsychiatric intervention is often effective and can result in an improved quality of life for the person, their family or carers. It can also result in reduced care needs and thus reduced costs of care.
Chances of improvement are usually better the earlier a person can access assessment and treatment.
Neuropsychiatric Intervention can often involve lengthy treatment with regular reviews of progress.
A GP or other medical consultant can make a referral to a neuropsychiatrist.
