Neuropsychiatry and neural cubism

The art movement known as Cubism did not represent a failure of perspective but, rather, was a movement aimed at advancing art by juxtaposing different perspectives. In this issue, Taylor and colleagues describe the current approach by neurologists and psychiatrists to patients with brain disorders as "Neural Cubism" because of the competing angles of these specialists' perspectives about these disorders. They advocate both integrated training for all residents in the two fields and a system of "nested hierarchies" to reclassify brain disorders according to their effect on levels of brain function. The unspoken premise of their article is that it is time for psychiatry and neurology to reunite.This Commentary takes the view that reuniting the long-separated specialties of neurology and psychiatry would not necessarily create better care for all patients with brain disorders but that trainees in both fields would benefit from increased training in the complementary specialty. The new Accreditation Council for Graduate Medical Education clinical neuroscience milestones for psychiatry training and psychiatry milestones for neurology training are steps in the right direction. Increasing opportunities for combined neurology-psychiatry training will help create a cadre of specialists equipped to efficiently care for complex patients within emerging accountable care organizations. Drawing from two fields in the service of understanding brain-behavior interactions increases the potential for innovation at their interface. The author concludes that the time has come to increase the neurological and neuroscience content of psychiatry training but not to unite the two fields.