It's A Big Word, Neuropsychology - Learn About It

I am sure that you have heard of ITTAR-C, and their tagline is, "Your mental health is our priority." Many of us will jump to the conclusion by saying only mentally ill people dem deal wid. The Ministry of Health and Wellness site has this to say about mental illness:

Depression is one of the common mental health diseases that affects our population. The prevalence of depression in Jamaica in 2016 was 14.3%, or 1 in every 7 persons.

Note that matters affecting the brain and mind cover a wide area. You might not have heard of the term "neuropsychology" or the need for a neuropsychological evaluation. Neuropsychological screenings are an experience that starts with a cognitive screen to help physicians detect signs of impairment outside the norm for a patient’s demographic and are clinically indicated in the following situations: 

1. When there are mild or questionable deficits on standard mental status testing or clinical interview, and a neuropsychological assessment is needed to establish the presence of abnormalities or distinguish them from changes that may occur with normal aging or the expected progression of other disease processes. 
2. When neuropsychological data can be combined with clinical, laboratory, and neuroimaging data to assist in establishing a clinical diagnosis in neurological or systemic conditions known to affect CNS functioning. 
3. When there is a need to quantify cognitive or behavioural deficits related to CNS impairment, especially when the information will be useful in determining a prognosis or informing treatment planning by determining the rate of disease progression.
4. When there is a need for a pre-surgical or treatment-related cognitive evaluation to determine whether one might safely proceed with a medical or surgical procedure that may affect brain function (For example, deep brain stimulation, resection of brain tumours or arteriovenous malformations, epilepsy surgery, or stem cell transplant) or significantly alter a patient’s functional status.
5. When there is a need to assess the potential impact of adverse effects of therapeutic substances that may cause cognitive impairment. For example, radiation, chemotherapy, and antiepileptic medications, especially when this information is utilized to determine treatment planning.
6. When there is a need to monitor progression, recovery, and response to changing treatments in patients with central nervous system (CNS) disorders, in order to establish the most effective plan of care.
7. When there is a need for objective measurement of the patient’s subjective complaints about memory, attention, or other cognitive dysfunction, which serves to determine treatment by differentiating psychogenic from neurogenic syndromes (for example, dementia vs. depression). 
8. When there is a need to establish a treatment plan by determining functional abilities/impairments in individuals with known or suspected CNS disorders.
9. When there is a need to determine whether a patient can comprehend and participate effectively in complex treatment regimens (For example, surgeries to modify facial appearance, hearing, or tongue debulking in craniofacial or Down syndrome patients; transplant or bariatric surgeries in patients with diminished capacity), and to determine functional capacity for healthcare decision-making, work, independent living,  and managing financial affairs.
10. When there is a need to design, administer, and/or monitor outcomes of cognitive rehabilitation procedures, such as compensatory memory training for brain-injured patients.
11. When there is a need to establish treatment planning through identification and assessment of the neurocognitive sequelae of systemic disease such as hepatic encephalopathy or anoxic/hypoxic injury associated with cardiac procedures.
12. For assessment of neurocognitive functions for the formulation of rehabilitation and/or management strategies among individuals with neuropsychiatric disorders. 
13. When there is a need to diagnose cognitive or functional deficits in children and adolescents based on an inability to develop expected knowledge, skills or abilities as required to adapt to new or changing cognitive, social, emotional, or physical demands. 

The next time you go with someone to the doctor with some of the challenges mentioned in this article, mention neuropsychological evaluation. This could make the difference in the patient's life.

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