Precision Psychiatry Care
Our Precision Psychiatry Care is a groundbreaking service designed to revolutionize mental health care by providing highly individualised advanced treatment plans. Utilising genetic testing, neurobiological, and psychological profiling, our assessment goes beyond traditional methods to uncover the unique factors influencing your mental health.
What is included?
- Psychiatric Assessment
- Neuropsychological Testing
- Advanced Structural MRI Scan
- Genetic Testing
- Precise Personalised Care
- Ongoing Monitoring and Adjustment
The Neuroevaluator
Using checklists can greatly improve the accuracy of diagnoses and treatment precision in psychiatry. We created special checklists, which we call “smart forms,” for all essential aspects of our psychiatric care. These smart forms adjust based on the information provided to find a balance between being detailed and staying relevant. We turned these checklists into a tool called the Neuroevaluator, and it has helped assess 1,566 clients since 2018.
The Neuroevaluator takes a deep dive into the factors that contribute to depression by exploring different areas of a person’s life. It considers early-life experiences, like childhood trauma—neglect, emotional, physical, or sexual abuse, growing up in poverty, losing a parent, or living with family members facing serious health challenges. Educational challenges, such as developmental conditions like dyslexia, ADHD, or autism, as well as bullying or difficult parenting, are also assessed.
Losses and fears, often linked to anxiety, are examined across various parts of life, including social standing, strained relationships, physical health, living environment, aspirations, work-related stress, finances, and personal security. The tool also evaluates family history, looking at inherited factors by analyzing the mental health of parents and siblings.
Medical conditions play a role too. Diabetes, heart disease, chronic pain, autoimmune disorders, thyroid issues, and complications with organs like the liver, kidneys, or heart, along with menopause, stroke, surgeries, and physical disabilities, can all impact mental well-being.
Abuse—whether sexual, physical, verbal, or financial—is carefully factored in, as are addictions, including those to internet gaming, alcohol, drugs, gambling, or pornography. Social issues like unemployment, isolation, and debt are considered, along with side effects from common medications for conditions such as hypertension or autoimmune disorders.
Finally, the Neuroevaluator accounts for other psychiatric conditions, including bipolar disorder, eating disorders, and personality disorders. This holistic approach helps provide a full understanding of the complex factors that contribute to depression, guiding personalized mental health care.
Special Investigations
In psychiatry, precision comes from using the right tests. Some are familiar, like blood tests that check for medical conditions such as hypothyroidism, which can impact mental health. Others, like MRI scans, provide a clearer view of the brain’s structure. More advanced methods, like genetic testing and functional brain scans, offer deeper insights into how the brain works.
Genetic Testing
Your DNA is uniquely yours, except for identical twins. Scientists believe decoding your DNA holds significant insights into your health. While understanding your DNA is becoming more accessible, we’re still learning about its complexities. What we know so far has been transformative. Genetic testing has proven crucial in various cases, enhancing client outcomes and reducing costs. Here’s how it helps:
Understanding Mental Health Problems Better
Decoding DNA improves treatment effectiveness. For instance, ADHD symptoms often arise from brain signal issues linked to low dopamine levels. While amphetamine-based stimulants help 78% of patients, 22% do not respond. Genetic testing can reveal why.
The COMT enzyme recycles dopamine, and genetic variations affect its efficiency. Some people have ADHD because their COMT recycles dopamine too quickly, not due to low production. This personalised approach is akin to choosing corrective lenses for vision problems.
Selecting The Best Treatment
Genetic testing can predict responses to various treatments, including medication, exercise, and therapy.
Folate (vitamin B9) is crucial for brain function, but some people can’t convert it to its active form, l-methylfolate, due to inherited enzyme issues (MTHFR). This can lead to symptoms like depression, making standard treatments less effective. Identifying MTHFR problems through genetic testing allows for targeted l-methylfolate supplementation, which can be transformative.
Faster Results at Lower Costs
In 2024, our genetic testing will cost around £800, utilizing the Genomind test for its clinical insights. Traditional depression care can be expensive, often costing £690 to £2760 over several appointments without guaranteed improvement. In contrast, genetic testing helps identify effective treatments faster and more cost-effectively.
The insights from genetic testing remain relevant for ongoing care. Investing in genetic testing can provide the best possible treatment for your depression. However, if your symptoms are mild and improvement isn’t urgent, traditional treatment may be adequate
Brain Scans
Structural Brain Scans
Functional Brain Scans
In addition to brain structure, assessing brain function is essential. This functional analysis is like test-driving a car, offering deeper insights. Key benefits include:
- Identifying abnormal brain functions related to ADHD, severe depression, and Alzheimer’s.
- Enhancing treatment effectiveness by targeting specific areas.
- Tracking treatment progress through changes in brain function.
For instance, fNIRS scanning revealed underactive brain regions in individuals with ADHD, correlating with poor performance. Neurofeedback targeting these areas led to improved activation and outcomes.
A cutting-edge area of functional neuroimaging is fMRI connectome scanning, which combines structural and functional imaging. While not yet clinically available in the UK, we’re working to make it accessible.
Modern Talking Therapy - EMDR & Specialists
In the UK, there’s no standard qualification for counsellors or psychologists, leading to inconsistency in the field. The term “talking therapist” can mean many things. While titles like clinical and counselling psychologist require specific training, they are exceptions.
This inconsistency makes it difficult for those seeking therapy to find qualified practitioners, resulting in varying care quality. However, there’s hope for effective treatment.
A precise approach involves skilled psychologists using advanced therapies like EMDR (Eye Movement Desensitization Reprocessing). Research shows that EMDR effectively treats post-traumatic stress disorder (PTSD), with a success rate exceeding 90%. The Neuroevaluator also helps identify complex PTSD from childhood traumas that might otherwise go unnoticed.
Neurotechnology Treatments
Recent advancements have led to a surge in treatments for various mental health conditions.
fNIRS Neurofeedback Training: This biofeedback therapy can produce lasting changes in brain activation, improving symptoms of ADHD, OCD, bipolar disorder, and depression. We specialise in this treatment and have achieved excellent results with the Neuroevaluator. We’re confident in its effectiveness and even offer a refund if clients don’t see improvements.
rTMS: This technique uses magnetic pulses to stimulate specific brain areas and has shown effectiveness in treating treatment-resistant depression. While our results with rTMS have varied, we believe that precision psychiatry methods for better patient selection will enhance outcomes.
tDCS: This non-invasive treatment applies a weak electrical current to stimulate neurons. We’re optimistic about tDCS’s potential and are collaborating with Flow Neuroscience to develop more effective treatments using their Flow device.
Novel Drug Treatments
Innovative uses of traditional substances show promise for treating mental health conditions. Among these are medicinal cannabis, ketamine, psilocybin, MDMA, and LSD. While CBD is widely available, its effectiveness in addressing mental health crises may be limited. In contrast, THC-rich medicinal cannabis has demonstrated potential benefits. Notably, many individuals with ADHD have found “full-fat” cannabis to be one of the most effective self-help treatments, likely due to its anxiety-reducing properties.
However, there are concerns about cannabis use, particularly regarding side effects like decreased motivation, known as amotivational syndrome. This is especially troubling for individuals with ADHD, as further impairing productivity may not be beneficial. Precision psychiatry tools can help identify effective treatments that enhance attention, mood, and productivity.
Ketamine is available in the UK, but I advocate for intravenous infusion (IV) under expert supervision as a more precise approach compared to the nasal spray. IV administration allows for tailored treatment and improved outcomes.
FAQs
Precision psychiatric services enhance treatment by customizing plans to fit your specific biological, psychological, and social factors, leading to more effective interventions. They also help in minimizing side effects and tracking treatment progress with advanced monitoring tools. This personalized approach increases the likelihood of successful outcomes and better overall management of mental health.