In our SUAM Feneryolu and Etiler Medical Centers, psychiatric and neurological diseases are diagnosed and treated. Our adult psychiatry unit monitors depression, bipolar mood disorder, schizophrenia, social phobia, panic disorder and other psychiatric diseases that show mild to moderate symptoms and 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 them. Psychotherapy practices are also performed in our adult and child adolescent units. Our neurology unit continues the treatment of neurological and neuropsychiatric pictures, that occur in parallel with the structural or functional deterioration of the brain in cooperation with our psychiatry unit.
Basic Approach in SUAM Polyclinics:
To clarify the diagnosis by first comprehensive examination and neuropsychological screening,
Afterwards to make a treatment plan with measurement-based methods,
It is to apply treatment by following the brain evidence with strong and adequate methods.
What is done in the first application?
Patients who are admitted to our psychiatry outpatient clinic for the first time (especially those who have previously received treatment but did not benefit from a treatment-resistant disease) are subjected to a detailed evaluation at the stage of diagnosis.
Neuropsychological Examination: If it has not been done in the last six months in patients over 65 years of age or people with forgetfulness and attention problems; Tests are used to measure high-level brain functions (planning, attention, concentration, memory, etc.). SPM for this; COG; DAUF; Computerized tests such as NVLT or a special group of tests applied by mutual interview technique, suitable for the patient's condition are used.
Profiling Personality: When necessary and in suitable patients; Tests such as MMPI and Rorschach are performed and personality traits are examined. It is understood whether the patient has a compelling personality structure that causes an intense anxiety or perception and / or thought disorder and thus causes deterioration in brain functions in the secondary process. Findings are used in the treatment process.
Neuroimaging: If it has not been done within the last six months; At least one of the Quantitative EEG (QEEG), Volumetric Cranial MRI examinations is taken to examine in detail whether there is any impairment 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 sleep disorder or suspicion of epilepsy, Polysomnography, which is thought to help the diagnosis, can be performed all night long by 12/24 hours of video monitoring EEG. The sleep profile of the patient is drawn and its relationship with the psychiatric / neurological picture is investigated.
Neurobiochemical Evaluation: If it has not been done in the last six months in patients over 65 years of age and if it is deemed necessary at younger ages; vitamins, minerals, amount of iron in the blood (anemia), blood sugar irregularities that can affect brain functions by performing blood and urine analysis; liver and kidney functions; The presence of widespread or brain-affecting infections is investigated.
Neuroendocrine Evaluation: The patient's complaints (ex. weight change, energy reduction, palpitations, tremors, memory-attention problems, etc.) if it is suspicious for certain diseases, weight measurement is done, thyroid, cortisol, prolactin, such as the psychiatric tables and brain functions associated with the levels of hormones are always looked at.
Toxic screening: in people with drug or addictive substance use that affects brain function, these substances are investigated in the blood/urine. It is repeated regularly at the start of treatment and during follow-up.
Clinical Pharmacogenetics Evaluation: In patients taking drug, drug blood levels rise above treatment values or drug interactions may lead to impaired brain function. To detect this, blood levels of the drugs used (TDM) are measured. In patients whose blood levels are extremely low or high at the average treatment dose, further analysis of the excretion of the drugs from the body is done to determine the genetic profile of the patient. Individual treatment is arranged with the data obtained.
Treatment Plan and Follow-Up Process:
Treatment plan is drawn up by evaluating the results of the examination. The treatment process is started by sharing with patients and their relatives. Psychotherapy (dynamic-oriented therapy, cognitive behavioral therapy, EMDR, hypnosis, Addiction Group therapies, Neurobiofeedback, REHACOM, play therapies in children) or brain stimulation techniques (ex. TMU) information and consent form is given to recommended patients. Drug blood level measurement (TDM) is a follow-up plan of drug treatment.