Columbia University Medical Center
NewYork-Presbyterian Hospital The University Hospital of Columbia and Cornell

Comprehensive Evaluations and Second Opinions

Columbia Psychiatry offers comprehensive diagnostic assessment and expert consultation for people age 18 and older with:

  • New onset of psychiatric, behavioral and emotional problems;
  • Conditions where the diagnosis is unclear;
  • Illnesses that have proven resistant to standard therapies;
  • Questions about treatment that require a second opinion; or
  • Conditions complicated by substance abuse and/or by medical illness.
Contact: 212-326-8441

Despite continued advances in psychiatry, some patients do not recover as fully as possible from their illnesses; others have complex problems that are difficult to understand. Psychiatric illnesses are often complicated by factors unique to each person, such as physical health, longstanding patterns of thinking and emotion, and family, education, and/or work issues. At Columbia Psychiatry all of these factors are taken into careful consideration as part of the evaluation so that we can tailor treatment recommendations to each patient’s diagnosis, preferences, and circumstances and maximize recovery. Patients have access to our world-class faculty and resources as part of the evaluation.

Who Can Benefit From an Expert Evaluation or Second Opinion?

Individuals who have developed new symptoms of emotional distress are often evaluated and treated initially by their primary general physician or a psychotherapist. However, a more complete diagnostic evaluation by a psychiatrist affiliated with a major academic medical center may be warranted in the case of ongoing depression, anxiety, agitation, or distressed thinking and behavior. Many research studies have shown that most patients with depression do not receive adequate treatment, even after seeing a doctor. Other studies show that most patients with bipolar disorder are improperly diagnosed for an average of eight years before they finally receive appropriate medication. Sitll other patients may have symptoms consistent with a personality disorder which persists many years unrecognized and untreated.  Our goal at Columbia Psychiatry is to help patients get the correct diagnosis and most appropriate treatment sooner.

There are many well-established medication treatments for depression, anxiety, bipolar disorder, or other psychiatric disorders. However, not all patients respond adequately or can tolerate the most common first-line treatments. In addition, exclusive reliance on medication without fully addressing other stressors in psychotherapy may cause incomplete treatment response. At times, the initial diagnostic impression turns out not to fit the emerging clinical picture and needs to be re-evaluated. Often, re-interviewing the patient from a fresh perspective, and talking with family members, can bring out additional information that places the patient’s problems in a new light.

At Columbia, we provide a careful diagnostic evaluation tailored to each individual’s needs and make detailed treatment recommendations so that medications and psychotherapy are prescribed only when needed.

Columbia Psychiatry specializes in reviewing ongoing treatment, often at the request of the doctors and other therapists already working with a patient. We provide constructive, innovative suggestions that often offer new directions when a patient is not responding to current treatment.

At Columbia Psychiatry, we see individuals for evaluations who live in the New York area, as well as those who come to see us from all across the United States and internationally.  While evaluations are typically done on an outpatient basis, stays within the hospital can be arranged as needed.  Following the expert evaluation, we are able to make arrangements for ongoing treatment, if desired, with a member of the Columbia faculty, or help with out-of-town referrals for patients who do not live in the New York area.  We can also take advantage of our department's extensive research community in assisting patients with state-of-the-art treatment recommendations.

Evaluation includes:

  • A review of past records, including hospital discharge summaries, psychological testing reports, prior consultation notes, and relevant medical records;
  • A review of the current treatment with the referring psychiatrist, therapist, and/or other physicians involved in the patient’s care;
  • Clinical interviews with a psychiatrist to explore the relevant issues;
  • Consultation with family members when appropriate;
  • Laboratory tests and referral for supplementary consultations with specialists in neuropsychology, neurology, and any medical specialties as indicated;
  • Psychological and neuropsychological testing as indicated; and
  • A written report that integrates the history, findings, diagnostic impressions, and recommendations.
  • For children and adolescents, we work with schools to assess the young person's academic functioning, help facilitate the qualification process for academic accommodations if appropriate, and provide guidance to families.

We partner with referring professionals to discuss our findings and recommendations.

Location:

ColumbiaDoctors - Midtown
51 West 51st Street
New York, NY 10019

Staff

Consultants:

Financial Information

Payment is made directly by the patient or the family at the time of service. Major credit cards are accepted. Fees for evaluation depend upon the extent of services and the specialists involved.
 

Contact

Please call us at 212-326-8441 to speak to a clinician to discuss a Columbia Psychiatry Comprehensive Evaluation or second opinion or discuss other specialized programs that may be right for you.

 

 

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