NPISTANBUL Hospital and Üsküdar University Feneryolu and Etiler Health Practice and Research Centers within NPGRUP offer resources to help you and your loved ones understand and intervene.
Basic processes;
- First, a comprehensive examination and neuropsychological screening to clarify the diagnosis,
- Then making a treatment plan based on measurement-based methods,
- Create a treatment plan
Accurate diagnosis is the first step for treatment planning. Patients presenting to our psychiatry outpatient clinic for the first time first undergo a psychiatric (and, if deemed necessary, an additional neurological) examination.
Patients who apply to our psychiatry outpatient clinic for the first time (especially those who have received treatment before but have not benefited from it, and those with treatment-resistant diseases) undergo a detailed evaluation during the diagnostic phase.
Neuropsychological examination: In patients over the age of 65 or in people with forgetfulness and attention problems, tests to measure brain functions (planning, attention, concentration, memory, etc.) are applied if they have not been performed within the last six months. For this purpose, computerized tests such as SPM; COG; DAUF; NVLT or a special group of tests administered by interview technique are used.
Personality profiling: When necessary and in appropriate patients, tests such as MMPI and Rorschach are used to assess personality traits. It is understood whether the patient has a compulsive personality structure that causes intense anxiety or perception and/or thought disorder and thus leads to impairment in brain functions in the secondary process. The findings are used in the treatment process.
Cardiovascular evaluation: Blood pressure and pulse rate measurements are performed in every patient. For those 65 years of age and older, those with cardiovascular complaints, those who use medications that carry cardiac risk and those who will start new medications, Electrocardiography (ECG) is performed.
Neuroimaging: If not performed within the last six months, at least one of Quantitative EEG [QEEG], Volumetric Cranial MRI examinations is performed to examine in detail whether there is a deterioration in the structure or functioning of the brain. If necessary, PET, SPECT, Functional MRI can be performed for further examination. For those over 65 years of age or with a complaint suggestive of a mental functioning/neurological disease, Cranial MRI or Computed Tomography is performed if it has not been performed within the last six months. Which imaging technique will be used is determined after the neuropsychiatric examination.
Sleep Laboratory: In patients with suspected sleep disorder or epilepsy, Polysomnography, EEG with 12/24 hour Video Monitorization all night can be performed. The patient's sleep profile is obtained and its relationship with the psychiatric/neurologic picture is investigated.
Neurobiochemical evaluation: If not performed in the last six months in patients over the age of 65 and if deemed necessary at younger ages; blood and urine tests are performed to investigate the presence of vitamins, minerals, iron content in the blood (anemia), blood sugar irregularities that may affect brain functions; liver and kidney functions; the presence of widespread or brain-affecting infections.
Neuroinflammatory evaluation: In patients over 65 years of age, if not performed in the last six months and if deemed necessary at younger ages; tests (blood, urine) such as ASO, CRP ... etc. are performed to show the presence of rheumatism in the body or a disease affecting the immune system and brain functions.
Neuroendocrine evaluation: The patient's complaints (e.g. If the patient's complaints (e.g. weight change, decreased energy, palpitations, tremors, memory-attention problems...etc.) arouse suspicion for certain diseases, weight measurement is performed and the levels of hormones such as Thyroid, Cortisol, Prolactin, which accompany psychiatric pictures and affect brain functions, are definitely checked.
Toxic screening: In people who use drugs or addictive substances that affect brain functions, these substances are investigated in blood/urine. It is repeated at the beginning of treatment and regularly during follow-up.
Clinical Pharmacogenetic Evaluation: In patients taking medication, drug blood levels above therapeutic values or drug interactions may lead to impaired brain function. To detect this, blood levels of the drugs used (TDM) are measured.
- NPISTANBUL Hospital and Üsküdar University Feneryolu and Etiler Health Practice and Research Centers within NPGRUP offer resources to help you and your loved ones understand and intervene.
- Our basic approach
- First, to clarify the diagnosis through a comprehensive examination and neuropsychological screening,
- Then make a treatment plan based on measurement methods,
- It is to apply treatment following brain evidence with strong and adequate methods.
- Correct diagnosis is the first step for planning the right treatment. Patients who apply to our psychiatry outpatient clinic for the first time first undergo a Psychiatric (and, if deemed necessary, an additional Neurological) examination.
- Patients who apply to our psychiatry outpatient clinic for the first time (especially those who have received treatment before but have not benefited from it, and those with treatment-resistant diseases) undergo a detailed evaluation during the diagnostic phase.
- Neuropsychological examination: In patients over the age of 65 or in people with forgetfulness and attention problems, tests to measure high-level brain functions (planning, attention, concentration, memory, etc.) are applied if they have not been performed within the last six months. For this purpose, computerized tests such as SPM; COG; DAUF; NVLT or a special group of tests administered by interview technique are used.
- Personality profiling: When necessary and in appropriate patients, tests such as MMPI and Rorschach are used to assess personality traits. It is understood whether the patient has a compulsive personality structure that causes intense anxiety or perception and/or thought disorder and thus leads to impairment in brain functions in the secondary process. The findings are used in the treatment process.
- Cardiovascular evaluation: Blood pressure and pulse rate measurements are performed in every patient. For those 65 years of age and older, those with cardiovascular complaints, those who use medications that carry cardiac risk and those who will start new medications, Electrocardiography (ECG) is performed.
- Neuroimaging: If not performed within the last six months, at least one of Quantitative EEG [QEEG], Volumetric Cranial MRI examinations is performed to examine in detail whether there is a deterioration in the structure or functioning of the brain. If necessary, PET, SPECT, Functional MRI can be performed for further examination. For those over 65 years of age or with a complaint suggestive of a mental functioning/neurological disease, a Cranial MRI or Computed Tomography is performed if it has not been performed within the last six months. Which imaging technique will be used is determined after the neuropsychiatric examination.
- Sleep Laboratory: In patients with suspected sleep disorder or epilepsy, Polysomnography, EEG with 12/24 hour Video Monitorization all night can be performed. The patient's sleep profile is obtained and its relationship with the psychiatric/neurologic picture is investigated.
- Neurobiochemical evaluation: If not performed in the last six months in patients over the age of 65 and if deemed necessary at younger ages; blood and urine tests are performed to investigate the presence of vitamins, minerals, iron content in the blood (anemia), blood sugar irregularities that may affect brain functions; liver and kidney functions; the presence of widespread or brain-affecting infections.
- Neuroinflammatory evaluation: In patients over 65 years of age, if not performed in the last six months and if deemed necessary at younger ages; tests (blood, urine) such as ASO, CRP ... etc. are performed to show the presence of rheumatism in the body or a disease affecting the immune system and brain functions.
- Neuroendocrine evaluation: The patient's complaints (e.g. If the patient's complaints (e.g. weight change, decreased energy, palpitations, tremors, memory-attention problems...etc.) arouse suspicion for certain diseases, weight measurement is performed and the levels of hormones such as Thyroid, Cortisol, Prolactin, which accompany psychiatric pictures and affect brain functions, are definitely checked.
- Toxic screening: In people who use drugs or addictive substances that affect brain functions, these substances are investigated in blood/urine. It is repeated at the beginning of treatment and regularly during follow-up.
- Clinical Pharmacogenetic Evaluation: In patients taking medication, drug blood levels above therapeutic values or drug interactions may lead to impaired brain function. To detect this, blood levels of the drugs used are measured (TDM).