. . . as the brain has the consistency of jelly, a sucker is the brain surgeon’s principal tool. . . . The idea that my sucker is moving through thought itself, through emotion and reason; that memories, dreams and reflections should consist of jelly is simply too strange to understand. All I can see in front of me is matter.
How does matter become mind?
How do meaning, memory, emotions and, especially, human suffering arise from the brain? These are unsolved mysteries that animate the field of psychiatry. And neuropsychiatry specifically focuses on this area of inquiry in search of improved diagnostics and therapeutics.
What is neuropsychiatry? And what is a neuropsychiatrist? The idea to write an article that would answer these questions emerged at the American Neuropsychiatric Association’s 2016 annual meeting, an opportunity for psychiatrists, neurologists, psychologists, and neuroscientists to explore their overlapping interests. During a coffee break at this year’s gathering, attendees were remarking that patients—and indeed the clinicians who refer them—seem to be perplexed about the difference between a “neuropsychiatrist” and a “regular psychiatrist.” We set out to dispel confusion about neuropsychiatry, but soon we discovered that this task was not as simple as we had expected.
Neuropsychiatry is both a way of thinking about mental disease and an approach to the practice of psychiatry. In addition, the term neuropsychiatry references the relationship between neurology, neuroscience, and psychiatry. The fundamental conceptual principle for the term neuropsychiatry is the idea that brain is the basis of behavior. But, beyond this pivotal notion, neuropsychiatry is evolving, both as a scientific field of study and as a clinical practice.
We are living at a particularly interesting scientific, technological, and cultural time in the 300-plus-year history of the emergence of neuropsychiatry. Many psychiatrists who are in practice today can recall the transformation of psychiatric practice that was sparked by the availability of effective psychotropic medication. Some psychiatrists began to practice as “psychopharmacologists.” At the time, this was a new area of specialization and needed to be defined for the general public. Now psychopharmacology is an essential aspect of virtually every psychiatrist’s practice. Will the burgeoning field of neuropsychiatry similarly be incorporated into mainstream thought and transform the psychiatric profession? In the future, will every psychiatrist be a neuropsychiatrist?
In this article, we discuss current, common uses of the term neuropsychiatrist. We also highlight how it is now possible to obtain subspecialty certification in the field of behavioral neurology and neuropsychiatry.
Dr. Schildkrout is Assistant Professor of Psychiatry, Part-time, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA. Dr. Frankel, board certified in geriatric psychiatry, is Consultant, NewBridge on the Charles campus of Hebrew SeniorLife, Dedham, MA, and teaches geriatric psychiatry at the Harvard Longwood Psychiatry Residency program. The authors report no conflicts of interest concerning the subject matter of this article.
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