INTEGRATION OF NEUROPSYCHOLOGICAL AND BEHAVIORAL NEUROLOGICAL ASSESSMENT IN PSYCHIATRY - A CASE EXAMPLE INVOLVING BRAIN INJURY AND POLYPHARMACY

WE present a case example that highlights the need for careful neurolo gic and neuropsychological reevaluations of psychiatric patients who s ustain head injuries, and also illustrates the concept that psychophar macological interventions may impair cognitive performance, especially in a brain-damaged person. As in a previous paper (Weinstein et al. 1 991), we emphasize the importance of a multidisciplinary diagnostic an d treatment approach that carefully considers psychodynamic, cultural, and neurobiological data. In our experience, a neuropsychological appr oach is particularly helpful in cases: (1) where brain dysfunction is suspected but focal neurological signs are not identified, and (2) whe re frank symptoms of medication toxicity are absent but cognitive impa irment is greater than expected.