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At least 19 recordsLinked to original sources
PubMed2002

The concept of neuropsychiatry: a historical overview.

The elusive nature of the social practice called neuropsychiatry is the most important obstacle for writing its history. At different times, and in different countries, the term has been used to name different ideological and professional packages. Choosing any of these as the prototype would, however, bias and regionalize the historical account. One solution is to identify an ideological marker or common denominator. To spin its yarn, this paper has chosen the foundational claim (putatively common to all practitioners of 'neuropsychiatry') that all 'mental disorders are disorders of the brain'. Three among its results are worth noting. One is that the meaning and exercise of 'neuropsychiatry' will continue to depend on social, economic and political factors; this augurs future instability. The second is that each time that the foundational claim has been uttered in history it has meant something different. Further research is needed to clarify whether this is due to the way in which the claim becomes 'inscribed' in different cultural niches; what is clear is that by using the foundational claim as a marker it is not possible to establish a continuity in the progress of neuropsychiatry. The third finding is that users of the foundational claim require the use of a concept of matter and in this paper 'plain' and 'baroque' types of matter have been identified. To explain the origin of mind, those using the plain notion need to resort to external ingredients and their narratives incorporate bits of the real world. Users of the baroque definition do not need such aids. It is not for the historian to judge which of these two definitions is more felicitous and more conducive to the moral and aesthetic edification of psychiatry and her patients.

Brain↗
PubMed2002

Assessment and measurement in neuropsychiatry: a conceptual history.

Since the time the parent discipline of psychiatry became organized as a profession, one of its ludi saeculares (neuropsychiatry) has enjoyed at least 4 vogues. On each, neuropsychiatry has been known to ally itself to a cause: currently it is the big business of neurobiology. This move can be seen as scientific progress or as a side-effect of the (professional rather than scientific) infighting that affected neuromedicine during the late 19(th) century and which led to the construction of the notion of "neurological disease." Alienists responded to this variously: some, like Kahlbaum and Kraepelin accepted the split and returned to the more botanico approach; others, like Ziehen chose psychology; yet others, like Freud, delved in hermeneutics; lastly, there were those, like Meynert, Wernicke, Von Monakow, and Liepmann who sought an accommodation with neurology. Born out of this compromise, neuropsychiatry has remained a blurred activity (whose definitions range from "psychiatry of neurology" to a crusade for the "naturalization of the mind"). Neuropsychiatric assessment is a methodology designed to collect information about patients whose mental symptoms are thought to be caused by brain disease. When it first appeared, it was torn by the debate between "nomothetic versus idiographic" science. For a time, the neuropsychiatry assessment techniques stuck to the old personalized narratives characteristic of 19(th) century "casenotes" (trying to meet its descriptive, explanatory, therapeutic, legal, and ethical obligations). But during the late 19(th) century, measurement and quantification became part of the new rhetoric of science. Soon enough this affected psychology in general and neuropsychology in particular and neuropsychiatric assessment followed suit. It has changed little since except that now and again old tests and markers are replaced by more "reliable" ones and phenomenological data are squeezed out further. Its laudable enthusiasm for objectivity and truth was ab initio justified by 19(th) century Positivism; currently, it seems to be supported by a naïve version of Popperian falsificationism. In the meantime, the scientific worth of the neuropsychiatric assessment remains unclear; indeed, in an age of evidence-based medicine, it is surprising that both its informational and communicational value and its efficiency as a general epistemic tool have not been subjected to any serious empirical testing.

Europe↗
PubMed2005

Cognitive neuropsychiatry: conceptual, methodological and philosophical perspectives.

Cognitive neuropsychiatry attempts to understand psychiatric disorders as disturbances to the normal function of human cognitive organisation, and it attempts to link this functional framework to relevant brain structures and their pathology. This recent scientific discipline is the natural extension of cognitive neuroscience into the domain of psychiatry. We present two examples of recent research in cognitive neuropsychiatry: delusions of control in schizophrenia, and affective disorders. The examples demonstrate how the cognitive approach is a fruitful and necessary supplement to the otherwise successful biological psychiatry paradigm, which tend to bypass the cognitive level. Philosophy concerns some of the core concepts involved in psychiatric illness, particularly concerning rationality, thought and action, reality testing, and the self. We present concrete examples that illustrate how philosophical conceptual tools can be particularly important for the construction and interpretation of the cognitive models relevant to the understanding of psychiatric illness. We conclude that cognitive neuropsychiatry is a fruitful and necessary supplement to biological psychiatry. Furthermore, cognitive neuropsychiatry itself may benefit significantly from employing philosophical conceptual tools in the interpretation and construction of its cognitive models. The cognitive and philosophical approaches may thus be further steps towards a scientific psychopathology.

Biological Psychiatry↗
PubMed2004

Neuropsychiatry: a management model for academic medicine.

Neuropsychiatry has become the subject of a number of editorials and position papers in recent years. Historical, philosophical, clinical, scientific, and educational dimensions of neuropsychiatry have been discussed in these papers. The potential business aspects of this topic, however, have received little, if any, comment. In this paper, the authors describe the business performance characteristics of an integrated neuropsychiatry department, formed through the merger of two traditional departments of psychiatry and neurology. The merger of neurology and psychiatry to create an integrated neuropsychiatry department according to the model described produced significant improvement in financial performance.

Education, Medical, Continuing↗
PubMed2006

Core curriculum for training in behavioral neurology and neuropsychiatry.

Recognizing the fundamental congruence between behavioral neurology and neuropsychiatry, the Joint Committee on Subspecialty Certification of the American Neuropsychiatric Association (ANPA) and the Society for Behavioral and Cognitive Neurology (SBCN) assert that these historically separate but parallel disciplines can be merged into a single subspecialty area of medicine: Behavioral Neurology & Neuropsychiatry. The authors first describe the historical background for the development of this medical subspecialty. Second, the goals and objectives for training in Behavioral Neurology & Neuropsychiatry are outlined. Finally, a core curriculum for fellowship training in Behavioral Neurology & Neuropsychiatry developed by SBCN and the ANPA is presented.

Behavioral Sciences↗
PubMed1995

[Neuropsychiatry and neuropsychology].

The 17th centuryś origins of neuropsychiatry are found in the works of Thomas Willis, who introduced the terms 'psychologia' and 'neurologia' and developed a complete neuropsychiatric concept. His views were revived by 18th-century animists and vitalists who were able to accept body-mind interactions, unlike the followers of Leibniz (e.g. Haller) who stuck to his psychophysical parallelism without possible interaction. This was also the creed of John Hughlings Jackson, whose influence on the development of neuropsychiatry and neuropsychology in the first decades of the 20th century was second to none. Neuropsychiatry, a Germanic specialty, was able to germinate in 1845 in Griesinger's 'Pathology and therapy of mental diseases', after Gall, Mesmer, Johannes Müller and many others had reformed and expanded the concept of mind-body interaction. In the second half of the 19th century, in the German-speaking countries progress in both neurology and psychiatry was usually achieved by neuro-psychiatrists. Neuropsychology (Lashley, 1913) was a product of both Jacksonian and Germanic neuropsychiatric ideas. During the 20th century neurology was separated from psychiatry, but new trends and their names such as 'psychobiology' and 'biological psychiatry', although quite old, are suggestive of a new kind of neuropsychiatry.

Europe↗
PubMed2001

Cognitive neuropsychiatry: towards a scientific psychopathology.

Cognitive neuropsychiatry represents a systematic and theoretically driven approach to explain clinical psychopathologies in terms of deficits to normal cognitive mechanisms. A concern with the neural substrates of impaired cognitive mechanisms links cognitive neuropsychiatry to the basic neurosciences. The emergence of cognitive neuropsychiatry in the 1990s illustrates the growing rapprochement between cognitive neuropsychology, clinical medicine and the neurosciences in addressing common questions about disorders of the mind/brain. In reviewing recent applications, we highlight how this hybrid discipline will make a distinctive contribution to the science of psychopathology.

Brain↗
PubMed2002

Neuroimaging in neuropsychiatry.

Advances in physics, computing, and signal processing have provided a range of computerized brain imaging technologies that facilitate examination of the brain as a dynamical system. This article provides a review of brain imaging advances and their application in neuropsychiatry. The review encompasses (1) a description of the imaging technologies used in neuropsychiatry; (2) an outline of their temporospatial complementarity; (3) application to clinical applications; and (4) suggested future directions including an "integrative neuroscience" approach to neuropsychiatry (in which theoretical models, data and information concerning mechanisms are integrated). In the absence of a unified theory of the brain, an integrated approach is presented as one means of exploring converging brain-imaging evidence in relation to neuropsychiatric disorders.

Brain↗
PubMed2002

Clinical presentations in neuropsychiatry.

In this report, the special clinical presentations found in neuropsychiatry are discussed. The point is made that conventional diagnostic schedules such as DSM-IV do not serve neuropsychiatry well, and have contributed to a failure to view neuropsychiatry as an independent specialist discipline. In this review some of the characteristic neuropsychiatric syndromes seen in epilepsy, movement disorders, demyelinating, and cerebrovascular diseases are described, followed by a brief discussion of conversion disorder. A plea is made that any future diagnostic schedules contain references to neuropsychiatric disorders and presentations.

Cerebrovascular Disorders↗
PubMed2006

Update in neuropsychiatry: cognition, sleep and sleep-related disorders.

The 17th Annual Meeting of American Neuropsychiatric Association was held in La Jolla Torrey Pines, San Diego, California, U.S.A., on February 18-21, 2006. The meeting was jointly sponsored by the Center for Continuing Medical Education (CME), the Ohio State University Medical Center and the American Neuropsychiatric Association. The primary objectives of the meeting were to define and describe contributions of cognitive neuroscience, the relevance of sleep disorders to neuropsychiatry and assessment of malingering in clinical evaluation. The report provides a comprehensive outlook and addresses several aspects of neuropsychiatry such as behavioral neurology, amnesia, cognitive correlates of functional status, emotions, neuropsychiatry of sleep and related disorders, insomnia, narcolepsy and other disorders, all strongly linked with other areas of science. The conference was made up of the familiar mix of symposia, poster presentations, workshop and sociocultural programs.

Cognition↗
PubMed2003

Toward a molecular neuropsychiatry of neurodegenerative diseases.

Quantitative neuropsychiatry has provided increasingly precise descriptions of behavioral phenotypes associated with neurodegenerative disorders. Degenerative diseases of the brain are disturbances of protein metabolism, with failure of protein degredation by the ubiquitin-proteosome system, production of neurotoxic peptide oligomers, and accumulation of intracellular protein deposits. Abnormalities of amyloid beta peptide, alpha-synuclein protein, and hyperphosphorylated tau protein account for more than 90% of degenerative dementias. Functionally related neuroanatomical systems have shared metabolic characteristics and common vulnerabilities to protein dysmetabolism, providing the basis for phenotypes that reflect the underlying proteotype. Patients with alpha-synuclein disorders are particularly prone to hallucinations, delusions, and rapid eye movement sleep behavior disorder. Patients with tauopathies manifest disproportionate disinhibition and apathy, and may exhibit compulsions. Alzheimer's disease is a triple proteinopathy with abnormalities of A-beta, tau, and alpha-synculein leading to a complex behavioral phenotype. This molecular approach to neuropsychiatry may assist in understanding the mechanisms of degenerative diseases, provide insight into the pathophysiology of neuropsychiatric symptoms, and contribute to monitoring disease-modifying therapies.

Alzheimer Disease↗
PubMed2005

WAIS-III General Ability Index in neuropsychiatry and forensic psychiatry inpatient samples.

The purpose of this study is to examine the WAIS-III General Ability Index (GAI) in a sample of 33 neuropsychiatry inpatients and 47 forensic psychiatry inpatients. The GAI is comprised of the six subtests that form the Verbal Comprehension and the Perceptual Organization Indexes. The GAI, although highly correlated with the FSIQ, was on average 5.3 points higher in the neuropsychiatry sample and 4.2 points higher in the forensic psychiatry sample. The GAI was significantly higher than the Working Memory and the Processing Speed Indexes in both groups. The GAI, a composite measure of verbal and nonverbal intellect, appears to be an appropriate measure for use in day-to-day clinical practice in neuropsychology. To facilitate clinical use, statistically reliable difference scores between the GAI and the WMI and PSI, for the 95% confidence interval, are presented.

Adolescent↗
PubMed1996

What's wrong and what's right in neuropsychology and neuropsychiatry.

There has been a recent converging of interests by psychiatrists and psychologists in subjective mental phenomena. Examples of topics where these converging interests arise include the relationship of confabulation and delusional memories, the nature of face-processing deficits in prosopagnosia and the Capgras delusion, and hierarchial models of psychological function. These developments are very much welcomed; but the over-interpretation of neuropsychological test findings in neuropsychiatry, and the occasional failure to take account of clinical context (particularly the psychiatric background) in neuropsychology, are also noted. Cognitive neuropsychiatry appears to have emerged as a label to identify this converging of interests, modelling itself on cognitive neuropsychology. The potential benefits and limitations of such an approach are discussed.

Journal Article↗
PubMedDate not supplied

A neural systems-based neurobiology and neuropsychiatry course: integrating biology, psychodynamics, and psychology in the psychiatric curriculum.

OBJECTIVE: Psychotherapy and biological psychiatry remain divided in psychiatry residency curricula. Behavioral neurobiology and neuropsychiatry provide a systems-level framework that allows teachers to integrate biology, psychodynamics, and psychology. METHOD: The authors detail the underlying assumptions and outline of a neural systems-based neuroscience course they teach at the National Capital Consortium Psychiatry Residency Program. They review course assessment reports and classroom observations. RESULTS: Self-report measures and teacher observations are encouraging. By the end of the course, residents are able to discuss both neurobiological and psychodynamic/psychological concepts of distributed biological neural networks. They verbalize an understanding that psychology is biology, that any distinction is artificial, and that both are valuable. CONCLUSIONS: A neuroscience curriculum founded on the underlying principles of behavioral neurobiology and neuropsychiatry is inherently anti-reductionistic and facilitates the acquisition of detailed information as well as critical thinking and cross-disciplinary correlations with psychological theories and psychotherapy.

Brain↗