When do you recommend neuropsychiatric testing in patients with post-concussive syndrome?

I typically ask the patient what scenarios they experience cognitive issues. The various examples they provide usually relate to difficulty following conversations, forgetfulness within their working memory, and concentration/focus. In the post-concussion patient, they typically have developed adjustment disorder with anxiety and/or depression, sleep issues, life stress from relationship strains or financial strains, and they may be having headaches or neck pain or other body pain from their inj...

I strongly concur with Dr. @Dr. First Last's statements. It is important to delve into the patient's premorbid psychosocial condition. Under conditions of major psychological and physiological stress, such as history of abuse, major job/family stress, occurrence during a prolonged fight/mugging or combat, there is a much greater likelihood of prolonged (> 2 weeks) symptomology as well as contributing factors such as sleep disturbance and exacerbation of potential premorbid mood disorder. An impo...

I do if:

1. It has been more than six months since the trauma and no recovery or improvement has happened especially if the imaging studies are normal with no clear parenchymal or cortical damages.
2. There is potential gain from the symptoms of post-concussion, i.e, disability of financial rewards.
3. Legal issues: any time lawyers are involved! The tests are ignored due to relying on short office-based cognitive tests that do not include personality traits.
4. If I am suspecting attention disorders. If s...

I would do this if there is any chance of a lawsuit arising from the injury, or if return to work is an issue. Neuropsychologists not only document subtle neuropsychological deficits, but they also have embedded measures of effort during the testing, which would detect embellishment or exaggeration of deficits.