psychiatric vs neuropsychologist

Discussion in 'General Parenting' started by klmno, Jan 4, 2009.

  1. klmno

    klmno Active Member

    MWM or others- I keep hearing here (I think) that there is a difference between a neuropsychologist and a psychologist, phd. A psychiatric, phd, did neuropsychologist testing on my difficult child almost 3 years ago- at least that is what is says on the report in very big bold letters. However, she told me that since she works with difficult child's psychiatrist, she did not diagnosis psychiatric disorders, including but not limited to bipolar.

    I looked in phone book and online for licensed providers in virginia and I can't find a neuropsychologist listed under mental health care providers or health care providers. I see psychologists listed and neurologists listed. Is it just that my state doesn't have a separate classification for neuropsychs? Am I looking in the wrong place? If it's a psychiatric phd licensed to do neuropsychologist testing, is it the same thing? It was the costly LONG testing that she did, however, I can't swear that she did ALL tests.
  2. klmno

    klmno Active Member

    Well I just looked on the site for the board of professional neuropsychs and there are only 6 listed in this whole state. I live in an urban centralized location and 1 is listed for this area. The others are 100 miles away. This is not a very progressive area- especially when it comes to mental health, but you talk to people that are born, raised, and stayed here and you'd think they were more innovative and better than any other place in this country.
  3. crazymama30

    crazymama30 Active Member

    There is a difference. I cannot find neuropsychologist in the phone book, but when I called a large teaching hospital, they have them there. That is the only place I have been able to find them around here. link to neuropsychologist link to psychologist.

    The way I understand it, a neuropsychologist specializes in neurological type disorders, Pervasive Developmental Disorder (PDD), asperger's, so on. A psychiatrist specializes in things such as ADHD, Bipolar, Schizophrenia.

    In my state, a psychologist cannot prescribe medications, does therapy, and I do not know if they can diagnose. I think the previous things can vary by state.
  4. klmno

    klmno Active Member

    Thanks! I'm looking in regards to testing. I'm wondering if the "neuropsychologist" testing and ability to diagnosis, make recommendations, etc., would be any different if done by these two different professionals. I am sure that I would have NO faith in the psychiatric's ability to diagnosis bipolar- no matter how long she tested difficult child. Mainly because I don't see how 5 days of testing could diagnosis it. I was told that there is no test for it and quite frankly, wouldn't the test results have a lot to do with whether or not the kid was depressed, manic, or stable that period of testing?

    If a person tests my difficult child the entire month of June, they might detect executive functioning issues, restlessness, etc., but how on earth is that going to let them know that he's depressed every fall and manic every late winter/early spring? And teachers' and parents' forms- pleeeaaase- they ALL point to adhd. ("Has your child EVER done ABC?????") There is no form that I've seen that says "does your child do XYZ often at certain periods then hardly ever do them at other periods".

    Sorry- I'm frustrated....

    A neurologist isn't the same thing as a neuropsychologist is it?
  5. smallworld

    smallworld Moderator

    What is the name of the association where you checked the neuropsychologists in your area? I'd like to check my area to see who is listed and whether they're the ones we went to.

    A neurologist is a medical doctor specializing in disorders of the central nervous system. A neuropsychologist is a psychologist who has extra training in how the brain functions. In general (may vary by state), only a psychiatrist can diagnosis bipolar disorder. It typically takes about 5 years to really nail down the diagnosis (we've been working with J's psychiatrist for 3 years, and he's pretty certain J has BiPolar (BP), but he wants to wait until J finishes puberty to make a definitive diagnosis).

    A PhD psychologist can do neuropsychological testing, as long as he/she is trained to do it.
  6. klmno

    klmno Active Member

    Thanks Smallworld!! That makes me feel better!! That is consistent with what psychiatrist and the psychiatric who tested difficult child told me.

    As far as where I looked- I looked in yellow pages (old fashoined, yes!), and on the website for online license lookups of the state health professions (I just looked at list of professions and there wasn't any "neuropsychologist" listing in this state for professional license- at least where I looked. You could do a search for Maryland Board of health care or mental healthcare and it should give you a site where you can check.)

    But, then I found this:

    You can choose your state and and will list all that belong to this board, presumably.
  7. DazedandConfused

    DazedandConfused Active Member

    How I found the neuropsychologist for son was from the Pediatric Neurology unit of a children's Hospital nearest to us. Pediatric Neurologists usually know of some and may even recommend one to you. Plus, they know what you talking about and you don't have to explain (hopefully!) what a Neuropsychologist does. Some work for the hospital and some are in private practice.

    Daughter was tested by one through a children's hospital-not the same one that I used to find one for Son because we had moved. Her pediatric hematologist recommended that I have it done when she was struggling developmentally and I wanted to be sure the chemotherapy regime to treat her leukemia hadn't caused brain damage.

    Son saw one recommended by a Pediatric Neurologist that I had taken him to see. The Dr. gave me a list and checked off the ones he said were good. I could have taken him to see a hospital neuropsychologist but he would have been put on a year long waiting list. I decided to take him to one that use to work at the hospital, but had gone into private practice. I had to self-pay (three grand), but it did answer some questions, but it also posed questions that don't have clear answers.
  8. TerryJ2

    TerryJ2 Well-Known Member

    If you PM me, I can tell you who not to go to. :)
    And I can tell you who finally did our testing the way I needed it done. We had the testing done twice, once when difficult child was 8, on the Peninsula, and again this past yr, when he was 11, in Norfolk. If that didn't pan out, I was going to go to Richmond, and then to MD.
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    They are at University and Children's hospitals. They catch a lot of things that psychiatrists don't or can't. Often certain neurological disorders are blamed on psychiatric problems--this is what happened to my son.
    My neuropsychologist also gave me the MMPI test, which is a 500 plus psychiatric test questionnaire, standard for adults who go into p-hospitals. It IS diagnostic. So ours did do a bit with psychiatry. He seemed to know a lot about psychiatric disorders as well as neurological.
    There is no way to 100% diagnose a psychiatric disorder. There is no blood test, no definite smoking gun.
  10. smallworld

    smallworld Moderator

    FYI, some neuropsychs are in private practice (ours were), but you would need to ask your pediatrician, psychiatrist or neuro to locate them. We happen to live in a major metropolitan area, however, so there might be more neuropsychs here than in less populated areas.

    J's neuropsychologist did a lot of diagnostic questionnaires as well as personality testing. But he still came up with Major Depressive Disorder with a rule-out on Bipolar Disorder as his diagnosis because he didn't see the mania (it is episodic), just the depression at the time of the evaluation.
  11. klmno

    klmno Active Member

    Thanks!! Terry- I'm in a bit of a hurry right now- I worked on the IEP some last night and need to email principal and cm this morning- difficult child is on his way to school!! If you could PM me and let me know of any around my area that yoou wouldn't recommend, that would be great! I wouldn't want to drive more than an hour to go to one. I can call the place where the MDE was done- they didn't do testing because I took them a copy of the report from testing done 18 mos earlier.

    He has been up half the wee hours of the morning, had showered (even though he did that before going to bed), ate breakfast and was pacing the floor by the time I got up. I mentioned that I thought he was a bit hypomanic so if a teacher ask him a question...then he finished the sentnece by saying "what, don't take the whole class period answering the question?" I said "yeah, I think you are getting it!" (This really might be as much excitement and anxiety as hypomania- not sure, but at least he notices to and is starting to realize more how it effects what he does.)

    MWM- I can see a questionnaire used like that for adults. I remember though that the psychiatric who tested my son said there were some things she couldn't give him because he was too young to be able to answer those questions about himself. She also recommended that I take him to a neurologist to be checked and have a complete physical done by his pediatrician just to rule out other things, which I did. The neurologist reviewed the report, met with us together and separately, did some tapping around on difficult child, etc., had a sleep deprived EEG done, then sent a letter saying the only other consideration would be a possible neurolinguistic problem - I think NonVerbal Learning Disorder (NVLD)- but that was probably not a real big problem- just something little he thought would be looked at by the ed spec on the MDE. The ed spec on the MDE mentioned it as a possibility because of the way difficult child was slow to answer questions and not speaking up clearly, but the psychiatrist who lead that team said she thought it was more of a symptom of the mood disorder or side effect of medications, not the underlying order. I agree with that because I know difficult child was nervous in a rooom full of profs with all of us discussing his hx and diagnosis. And, I've been around him many times when he does speak very clearly and is quick to respond with bright answers- also, I've experienced his excessive talking phases, too.

    SW- difficult child's diagnosis on testing was Major Depression and Disruptive Behavior not otherwise specified (this was due to erratic behavior that I had reported) with a rule out of ODD and borderline ADHD. His psychiatric hospital psychiatrist (he had just been released from psychiatric hospital for his first acute stay) was Major Depression, rule out Bipolar and/or CD.

    I'm pretty comfortable when I look at it all together- anxiety and depression run in my family. Regular psychiatrist is starting to see anxiety more and more in difficult child. Maybe anxiety triggers mania, I don't know- let's say it might trigger erratic behavior. MDE psychiatrist said she thinks difficult child might not need MS's in the future if he gets adequate therapy now and hormones stablize after puberty, but he needs them now. She said he might just end up with a Generalized Anxiety Disorder (GAD) that he can manage without medications- like his Mom :).

    difficult child's therapist (psychiatric, phd) does testing but I would prefer a nueropsych do it if I can afford to have them done again soon. I'd like to. Would there be any advantage or disadvantage to having difficult child's therapist do testing on him? My only concern would be that he hasn't seen the full spectrum of difficult child yet and I wouldn't want preconceived ideas to dominate his evaluation. It's a bit like putting "all eggs in one basket" too.

    I mainly want them done again for issues pertaining to school performance and just to see if anything else might be revealed that could help us tweak the treatment plan. It will be 3 years in March since his first ones were done.
    Last edited: Jan 5, 2009
  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    My NonVerbal Learning Disorder (NVLD) was devestating. I can't recognize faces of people. I can't perform well, although I speak well. in my opinion that deserves A LOT of attention. It's like Aspergers, only you're a little more social, however you do lack social skills. I also have depression and anxiety--I think it all goes together. I have always had a horrible time keeping a job because I will sound uber-intelligent when I speak (great verbal skills), but I will never be able to perform up to my verbal ability. I can't even do factory work because putting things together confuses me. I think NVLDs are serious. JMO
  13. robinm1922

    robinm1922 One day at a time

    I don't know if this helps or not, I just took difficult child to for a neuropsychologist consult and was surprised at the outcome. My difficult child was diagnosed in April with Major depression and Obsessive Compulsive Disorder (OCD) (slight and more obsessive than anything else) it was suggested here and at a support group that I have her seen by a Neuropsychologist. I did on Friday and there is enough to indicate she may have a slight ADD/ADHD issue. I was told that this could have pushed her into a depression and that all of them could be related. He recommended more testing and right now am keeping my fingers crossed that the insurance company and her birth father (we have joint custody so he needs to give permission for testing) come through so we can get going with the tests.
    He did recommend a non-stimulant ADHD medication which I will talk to her psychiatrist about when we go in a couple of weeks. I would have thought this would have shown before now, what was explained to me was this - her case looks to be mild and more along the language and comprehension (according to test results he had from the school) and as she progresses in grades and school becomes harder and faster moving the more the problem will surface. With the added pressure of school and not being able to keep up like she thinks she should brought on the depression. At least that is what he thinks. Not to mention there was a bunch of stuff with her birth father going on at the same time.
    Now it is on to the other board to see if anyone has tried a non-stimulant ADHD medication.

    I looked at the link you put in your post and the dr I went to was not listed on the link. You may have better luck doing a general search.
    Best of luck!
  14. klmno

    klmno Active Member

    MWM- I don't think difficult child truly has a NonVerbal Learning Disorder (NVLD)- the test results didn't show any. I didn't mean to imply that a learning disability was uncovered but I'm not taking it serious. Although I will say that twice he was tested for adhd and once he met criteria (barely) and the other time the test was inconclusive and I told psychiatrist I did NOT want difficult child on stims and that I don't think it's really adhd because it switches on and off with the other unstable indicators.

    I had NonVerbal Learning Disorder (NVLD) term all wrong- I just re-read the letter from the neurologist- it said he noticed that difficult child's test scores met criteria for adhd (which was written in there and we know) and that he "noticed that most scores were average or above average in achievements and cognitive function areas" (not executive functioning- it was low), but "there were some low scores in language based areas and that difficult child had not had a neurolinguistic assessment which might should be considered". Then, he said the upcoming MDE with the ed spec (this was all done the fall of 2007) could address the question of a language base communication disorder. He went on to explain that sometimes kids who seem/act ODD or ADHD might not be either but might really be having difficulty understanding because of a communication defecit.

    If testing is done again and it uncovers more along those lines, I definitely would want it addressed. But, I think so far the prof's concluded that difficult child's verbal responses that could indicate a language based deficit turned out not to be a serious problem, based on review of test results and MDE and psychiatrist understanding side effects of MS's- mainly depakote.

    If I can't get complete testing done again, it might be worth it to just have this assessment done, however, I'd prefer to get the complete testing done.
    Last edited: Jan 5, 2009
  15. Nancy423

    Nancy423 do I have to be the mom?

    The neuropsychologist the school is sending us to isn't listed anywhere and he's private practice. The other dozen or so I found in the area (50 miles radius, includes a HUGE city) were thru my insurance website. They were all in-network. See if your ins. has a listing.