The Department of Psychiatry at New York Presbyterian Hospital/Columbia University Medical Center offers comprehensive diagnostic assessment and expert consultation for people age 18 and older with:

Despite continued advances in psychiatry, some patients do not fully recover 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. All of these factors are taken into consideration as part of the evaluation so that we can carefully tailor recommendations to each patient’s diagnosis, personality style and circumstances.

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 may be warranted in the case of severe depression, anxiety, agitation, or seriously disturbed 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.

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 the emotional problems in psychotherapy may cause incomplete treatment response. At times, the initial diagnostic impression turns out not to fit the 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.

Experts at Columbia provide a careful diagnostic evaluation and make detailed treatment recommendations so that medications are prescribed when needed and avoided if not needed or potentially harmful. Psychotherapy recommendations are tailored to each patient.

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 help break stalemates when a patient is not responding to treatment. 

We are also available 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.

Evaluation include:

	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 by an expert from the senior Columbia Psychiatry faculty who will meet with the patient and the evaluating psychiatrist to discuss diagnostic impressions and treatment recommendations;
	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.

We remain available to referring professionals to discuss our findings and recommendations.

Cathy J. Friedman, MD, Director

Wilfred G. Van Gorp, PhD
Ina Becker, MD
Elizabeth Mirabello, MD
Jennifer Nogi, MD

You may call our general referral line for further information: 212-305-6001.

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.

Please call us at 212-305-7386.