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Bridging the Great Divide: What Can Neurology Learn From Psychiatry?
David L Perez1, Matcheri S Keshavan1, Jeremiah M Scharf1
1From 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).
Neurology and psychiatry can integrate by adopting a clinical neuroscience approach. This involves shifting to circuit-based, bidirectional, and transdiagnostic models for better brain disorder assessment and treatment.
Area of Science:
- Clinical Neuroscience
- Neuropsychiatry
- Brain Disorders
Background:
- Neurology and psychiatry share historical roots and tools but lack practical integration.
- Emerging advances in systems, molecular, and genetic neuroscience are underutilized in psychiatric science.
- Clinical neuroscience principles are less applied to neurologic conditions using a neurobio-psycho-social framework.
Observation:
- The relationship between neurology and psychiatry is historically complex.
- Psychiatric conditions are increasingly viewed as disorders of neurodevelopment and awareness.
- Many conditions bridge traditional neurological and psychiatric diagnostic boundaries.
Findings:
- Integrating neurology and psychiatry requires moving beyond lesion-based to circuit-based understandings.
- Bidirectional brain-behavior models and transdiagnostic dimensional perspectives are crucial.
- Interdisciplinary approaches are needed, moving away from siloed research and treatments.
Implications:
- An integrated clinical neuroscience approach is essential for assessing and managing brain disorders.
- Behavioral neurology and neuropsychiatry can lead the merger of brain science with psychosocial factors.
- This integration will advance translational research, training, and patient-centered treatments.
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