Results from psychological testing, brain imaging and pharmacogenetics guide treatment decisions. – Dr. Gerald Tramontano, Medical Director
Psychiatric Assessment
The goal of psychiatric exams and clinical psychological testing is to identify the cause of each patient’s neuropsychiatric symptoms and disorders. For example, to determine if a patient’s mood disorder is due to dysthymia or major depression; or to differentiate a bipolar spectrum disorder vs. a trait-based condition such as borderline personality disorder.
Accurately identifying the etiology determines the best treatment option which increases the likelihood of a positive outcome. These diagnostic procedures are always combined with a comprehensive developmental, social and medical history, as well as, a neurological examination to enhance the probability of making an accurate diagnosis or diagnoses.
Neuroimaging
Additionally, at NCI we use electrical neuroimaging to assess if a patient is a candidate for pharmacological interventions with stimulants or anti-depressants. Functional brain mapping using electrical neuroimaging and fMRI are routinely used to identify neuromarkers for neuropsychiatric conditions such as major depression, sympathetic over-arousal disorders such as OCD, PTSD, generalized anxiety and panic attacks, Tourette’s syndrome, as well as schizophreniform disorders.
Biological Testing
Assessing levels of neurotransmitters are typically included in our psychiatric assessment, as well as, neuroendocrine and micronutrient laboratory testing.
Pharmacogenetics
We also use pharmacogenetic testing to determine how each patient’s genes break down and metabolize psychotropic medications allowing the prescribing clinician to avoid medications that are likely to cause side-effects and to determine when higher dosages of a medication will be required to obtain a therapeutic effect.
Dose Optimization and Efficacy Testing
Once the correct medication is identified, such as a specific stimulant, we routinely use dose optimization testing to find the optimal stimulant dose or dosages across both low and high stimulating conditions. Similarly – all of our mental health treatments are followed by efficacy testing.
Mental Health Treatments
Psychotherapy
Psychotherapy is a core mental health treatment offered at NCI. There are hundreds of different
types of psychological therapies, but in general they can be broken down into two major categories:
cognitive behavioral and the psychodynamic based therapies.
Although there is a significant amount of overlap, Cognitive Behavioral Therapy (CBT) tends to focus on identifying and changing cognitions and behaviors that are thought to be causing or contributing to a patient’s psychiatric disorder. Psychodynamic therapies tend to focus more on bringing into the patient’s awareness unconscious defense or coping mechanisms that are actually contributing to the patient’s distress instead of protecting the patient.
Neuromodulation
At NCI, we also use non-invasive neuromodulation treatment applications such as transcranial direct/alternating current stimulation (tDCS/tACS) to treat various neuropsychiatric disorders. For instance, in some patients with mood and impulse control disorders, regulatory regions of the cortex respond inadequately to effectively modulate a patient’s mood symptoms and impulsivity. Interventions such as tDCS and tACS can enhance these regulatory hubs improving a patient’s capacity to self-regulate. Some of these interventions are available only through research and others have been FDA approved to treat certain disorders.
Psychopharmacology
Some of our clinicians at NCI specialize in the use of psychotropic medications in to treatment mood and behavioral disorders, as well as, psychosis.
Other Medical Devices
Devices to treat panic attacks and insomnia such as FreeSpira and ebb are routinely used by NCI clinicians as adjunctive treatments for the treatment of common neuropsychiatric symptoms.
Psychiatric assessments and mental health treatments are reimbursed by most third-party healthcare insurance carriers. NCI participates in most healthcare plans including Medicare and Medicaid.
Contact Us
If you or know anyone who needs help, contact The NeuroCognitive Institute for assessment and treatment. Call (973) 601 0100 or sign up as a new patient and we will get back to you as soon as we can.
