Diagnosis and treatment of psychiatric and neurological diseases are performed atSUAM Feneryolu and Etiler Medical Centers. Our adult psychiatry unit follows up depression, bipolar mood disorder, schizophrenia, social phobia, panic disorder and other psychiatric disorders with mild to moderate symptoms that can be treated on an outpatient basis. Our child-adolescent psychiatry unit continues the diagnosis and treatment of psychiatric conditions that develop in childhood or first appear in adolescence.
Common developmental disorders, childhood depression and anxiety disorders, attention deficit and hyperactivity disorder, learning disorders are some of these disorders. Psychotherapy is also provided in our adult and child-adolescent units. Our neurology unit carries out the treatment of neurological and neuropsychiatric conditions that occur in parallel with structural or functional disorders of the brain in cooperation with our psychiatry unit.
Basic approach in CPSU Outpatient Clinics:
- First, to clarify the diagnosis through comprehensive examination and neuropsychological screening,
- Then making a treatment plan based on measurement-based methods,
- To apply treatment following brain evidence with strong and adequate methods.
What is done at the first application?
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) are subjected to 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 applied by mutual 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.
Neuroimaging: If not performed within the last six months, at least one of the 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. 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, which is thought to help the diagnosis. The patient's sleep profile is obtained and its relationship with the psychiatric/neurologic picture is investigated.
Neurobiochemical Evaluation: In patients over the age of 65, if not performed in the last six months 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.
Neuroendocrine Evaluation: If the patient's complaints (e.g. weight change, decreased energy, palpitations, tremors, memory-attention problems, etc.) raise 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 tested 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 exceeding therapeutic values or drug interactions may lead to impairment in brain function. In order to detect this, blood levels of the drugs used (TDM) are measured. In patients whose drug blood levels are too low or too high at the average therapeutic dose, further analysis of the excretion of drugs from the body is performed and the patient's genetic profile is determined. Personalized treatment is organized with the data obtained.
Treatment Plan and Follow-up Process
The results of the tests are evaluated and a treatment plan is drawn. The treatment process is initiated by sharing it with the patient and his/her relatives. Patients who are recommended psychotherapy (Dynamic Oriented Therapy, Cognitive Behavioral Therapy, EMDR, Hypnosis, Addiction Group Therapies, Neurobiofeedback, REHACOM, Play Therapies for children) or brain stimulation techniques (e.g. TMU) are given an information and consent form. A follow-up plan of drug treatment is made with drug blood level measurement (TDM).