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Neuro-PsychiatristThe medical specialty that is committed to making understanding of brain-behavior relationships better and to care for individuals with neurologically-based cognitive, emotional and behavioral disturbances is known as Neuropsychiatry. A medical physician with an M.D. or D.O. is qualified to practice neuropsychiatry by virtue of (1) a primary training in either psychiatry or neurology followed by a period of more or less one year of fellowship training in neuropsychiatry or behavioral neurology; and (2) a training of formal residency in both psychiatry and neurology. Neuropsychiatrists with a lot of years of extensive clinical, educational, and scientific experience in the field of neuropsychiatry can also make use of specialty designations. Among the patients that are being treated by Neuro-Psychiatrists are neurologic illness and cognitive, emotional, or behavioral problems; individuals with combined psychiatric illnesses and neurologic conditions; and individuals with atypical or refractory primary psychiatric disorders in which the concerns are all about the underlying neurological conditions that are causing the psychiatric symptoms. To fully conceptualize what a Neuropsychiatrist is in the 21st century, one needs to center on the neurologic structure, chemistry and other dysfunctions involving the brain of the traditional psychiatric illnesses and also find within one’s scope of practice any and all behavioral manifestations from any other disease process as well. Neuro-Psychiatrists need to be aware of many diagnostic processes involving the different types of disease process. In order to remember all of them one needs to make use of the AEIOU TIPS mnemonic. • ‘A’ mnemonic stands for the word Accidents such as closed head injuries and traumatic brain injuries. This includes psychosis, depression, obsessive-compulsive disorders, irritability, profound personality changes, aggression and dysfunctions in memory. It is the responsibility of the Neuropsychiatrist to utilize of a higher cortical function in addition to physical examination giving a greater understanding of any deficits involving the dominant as well as the non-dominant, frontal and pre-frontal regions of the brains, the cerebellum and the motor tracts. The Neuropsychiatrists needs to know the prognostic signs of the injury. • ‘E’ is for Endocrine. Neuropsychiatrist should request for thyroid function and assay after the start or prior to the start of an anti-depressant medication prescription. • ‘I’ is for infection such as meningitis, encephalitis, pneumonias and or urinary tract infections. HIV diseases as well as other opportunistic infections also need to be considered in this category. • ‘O’ means oxygenation. Pulmonary dysfunctions sometimes result in problems of memory and agitation. • ‘U’ is for uremia and other metabolic disorders. Liver disease like kidney disease causes a significant mental status change as well as changes in metabolism of medications that the patients take. • ‘T’ stands for tumors. Neuropsychiatrists should be aware and comfortable of the CT scan readings, MRI scans that are essential for the final diagnosis and initiation of treatments. • ‘I’ is for infarctions and strokes because these two conditions cause an almost identical idiopathic syndrome that can generally be treated by the Neuropsychiatrist. • ‘P’ stands for Parkinsonism and other movement disorders. • ‘S’ is for seizures. By identifying each of the illness processes and categories, a Neuropsychiatrist needs to be able to perform not just physical examinations with an excellent degree of expertise, but must also be knowledgeable on how to evaluate the patients who are suffering from the different types of disorders. He or she must be able to know how to treat each of the disorders within the specialty appropriately or get consultations but primarily to be able to treat the behavioral manifestations. |
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