Neuropsychiatry is a branch of medicine that deals with mental disorders attributable to diseases of the nervous system. It preceded the current disciplines of psychiatry and neurology, which had common training.However, psychiatry and neurology subsequently split apart and are typically practiced separately. Nevertheless, neuropsychiatry has become a growing subspecialty of psychiatry and it is also closely related to the fields of neuropsychology and behavioral neurology, which is a subspecialty of neurology that addresses clinical problems of cognition and/or behavior caused by brain injury or brain disease of different etiologies.
Anxiety and attention deficit hyperactivity disorder (ADHD), are among the most frequently diagnosed of all neuropsychiatric disorders. Although many people can be treated with conventional medications, these drugs often have unwanted side-effects and may be diverted for illicit use. NEPRC scientists have made important contributions to our understanding of the biological basis and pharmacological management of anxiety and ADHD, and additional studies have provided new insights into the pathophysiology and treatment of self-injurious behavior (SIB).
Benzodiazepines are the most widely prescribed drugs for the treatment of anxiety, but their clinical effectiveness is limited by significant side-effects, including sedation, memory impairment, and dependence. NEPRC researchers have worked to develop better treatments for anxiety by helping to identify the neuropharmacological mechanisms underlying the anti-anxiety, sedating, and addictive effects of new drugs. Using a sophisticated battery of behavioral models, these studies have provided information that is crucial for developing safer and more broadly effective medications.
Using brain imaging techniques originally developed at NEPRC, our researchers have discovered elevated levels of a key component of the brain dopamine system, the dopamine transporter, in patients with ADHD. This discovery may put the medical community closer to developing more accurate diagnostic tests and better prescribing practices for the disorder. Complementary research has identified polymorphisms in the dopamine transporter gene and is investigating the effects of novel medications in subjects with different levels of behavioral activity in order to develop a more accurate understanding of the biological basis of ADHD.
Given the considerable overlap between these subspecialities, there has been a resurgence of interest and debate relating to neuropsychiatry in academia over the last decade. Most of this work argues for a rapprochement of neurology and psychiatry, forming a specialty above and beyond a subspecialty of psychiatry.This includes the following:
- Childhood and development
- Eating disorders
- Degenerative diseases
- Mood disorders
- Neurotic disorders
- Sleep disorders
Further, it is argued that this nexus will allow a more refined nosology of mental illness to emerge thus helping to improve remediation and rehabilitation strategies beyond current ones that lump together ranges of symptoms. However, it cuts both ways: traditionally neurological disorders, like Parkinson’s disease, are being recognized for their high incidence of traditionally psychiatric symptoms, like psychosis and depression (Lerner and Whitehouse, 2002). These symptoms, which are largely ignored in neurology, can be addressed by neuropsychiatry and lead to improved patient care. In sum, it is argued that patients from both traditional psychiatry and neurology departments will see their care improved following a reuniting of the specialties.