Journal article
Bridging the Great Divide: What Can Neurology Learn From Psychiatry?
The journal of neuropsychiatry and clinical neurosciences, Vol.30(4), pp.271-278
2018
DOI: 10.1176/appi.neuropsych.17100200
PMCID: PMC6309772
PMID: 29939105
Abstract
Neurology and psychiatry share common historical origins and rely on similar tools to study brain disorders. Yet the practical integration of medical and scientific approaches across these clinical neurosciences remains elusive. Although much has been written about the need to incorporate emerging systems-level, cellular-molecular, and genetic-epigenetic advances into a science of mind for psychiatric disorders, less attention has been given to applying clinical neuroscience principles to conceptualize neurologic conditions with an integrated neurobio-psycho-social approach. In this perspective article, the authors briefly outline the historically interwoven and complicated relationship between neurology and psychiatry. Through a series of vignettes, the authors then illustrate how some traditional psychiatric conditions are being reconceptualized in part as disorders of neurodevelopment and awareness. They emphasize the intersection of neurology and psychiatry by highlighting conditions that cut across traditional diagnostic boundaries. The authors argue that the divide between neurology and psychiatry can be narrowed by moving from lesion-based toward circuit-based understandings of neuropsychiatric disorders, from unidirectional toward bidirectional models of brain-behavior relationships, from exclusive reliance on categorical diagnoses toward transdiagnostic dimensional perspectives, and from silo-based research and treatments toward interdisciplinary approaches. The time is ripe for neurologists and psychiatrists to implement an integrated clinical neuroscience approach to the assessment and management of brain disorders. The subspecialty of behavioral neurology & neuropsychiatry is poised to lead the next generation of clinicians to merge brain science with psychological and social-cultural factors. These efforts will catalyze translational research, revitalize training programs, and advance the development of impactful patient-centered treatments.
Details
- Title: Subtitle
- Bridging the Great Divide: What Can Neurology Learn From Psychiatry?
- Creators
- David L Perez - From the Department of Neurology, Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP, BHP); the Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP); the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (MSK); the Department of Neurology, Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston (JMS); the Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston (JMS); the Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa (ADB); and the Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, Mass. (BHP)Matcheri S Keshavan - From the Department of Neurology, Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP, BHP); the Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP); the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (MSK); the Department of Neurology, Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston (JMS); the Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston (JMS); the Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa (ADB); and the Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, Mass. (BHP)Jeremiah M Scharf - From the Department of Neurology, Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP, BHP); the Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP); the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (MSK); the Department of Neurology, Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston (JMS); the Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston (JMS); the Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa (ADB); and the Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, Mass. (BHP)Aaron D Boes - From the Department of Neurology, Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP, BHP); the Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP); the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (MSK); the Department of Neurology, Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston (JMS); the Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston (JMS); the Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa (ADB); and the Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, Mass. (BHP)Bruce H Price - From the Department of Neurology, Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP, BHP); the Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston (DLP); the Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (MSK); the Department of Neurology, Movement Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston (JMS); the Department of Neurology, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston (JMS); the Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa (ADB); and the Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, Mass. (BHP)
- Resource Type
- Journal article
- Publication Details
- The journal of neuropsychiatry and clinical neurosciences, Vol.30(4), pp.271-278
- Publisher
- United States
- DOI
- 10.1176/appi.neuropsych.17100200
- PMID
- 29939105
- PMCID
- PMC6309772
- ISSN
- 0895-0172
- eISSN
- 1545-7222
- Grant note
- K12 NS098482 / NINDS NIH HHS K23 MH111983 / NIMH NIH HHS
- Language
- English
- Date published
- 2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Psychiatry; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurology (Pediatrics)
- Record Identifier
- 9984070889802771
Metrics
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