DOI: 10.1097/NMD.0b013e3181a2b45d
,
Issn Print: 0022-3018
Publication Date: 2009/05/01
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Excerpt
Stuart C. Yudofsky and Robert E. Hales (Eds). (2008) Arlington, VA: American Psychiatric Publishing, Inc. ISBN 978-1-58562-239-9. xxvii+1332 pp.
The history of neurology and psychiatry is marked by marriages and separations. While Aristotle described the meninges and distinguished between the cerebrum and the cerebellum, and in imperial Rome, Galen performed dissections of the nervous system in a variety of animal species, Hippocrates describing mania, delirium, and psychosis did not separate physical from psychological manifestations. The term “neurologie” was first used by Thomas Willis in his book “Anatomy of the Brain” (1664), but neurology developed as a separate discipline during the Renaissance. The word psychiatry—from the Greek “ψυχ???” (soul or mind) and “iατρóζ” (healer or doctor)—was coined by Johann Christian Reil in 1808. Before the 19th century, there was not a clear separation between the neurology and psychiatry. Jean-Martin Charcot, Sigmund Freud, Joseph Babinski, Georges Gilles de la Tourette, and many others were in essence all neuropsychiatrists.
Their followers began to shift paradigm. Neurology became focused on diagnosis and treatment of illnesses of central and peripheral nervous system, while the aim of psychiatry was treatment of behavioral illnesses. Implicit to this shift was that mental disorders may not have had a biological or neural substrate. In 19th and 20th century Europe and United States, neurology and psychiatry developed separately and trained their own future specialists.
The last 2 decades, have seen an inversion of tendency. The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences edited by Yudofsky and Hales is testimony of the development of a “new” branch of medicine: neuropsychiatry. In its renewed meaning, neuropsychiatry is a branch of medicine aimed at caring for and studying patients with mental disorders attributable to disturbances in the nervous system. Although today departments of psychiatry and neurology remain separate, neuropsychiatry as a subspecialty has received unexpected following.
The American Neuropsychiatric Association (active since 1988) has now over 600 members. Its meetings are held yearly and often together with the International Neuropsychological Society and the Society for Behavioral and Cognitive Neurology to underscore the kinship with these related disciplines. Behavioral Neurology or Neuropsychiatry fellowships are jointly accredited through the United Council for Neurologic Subspecialties. The specialties of psychiatry and neurology in the United States have a joint board for accreditation: the American Board of Psychiatry and Neurology.
While the separation of the departments of psychiatry and neurology in the United States is rooted in history, progress in neurobiology, genetics and diagnostic procedures suggest that the separation has grown conceptually thinner. Joseph B. Martin, Dean of Harvard Medical School and a neurologist by training, has summarized the argument for reunion: “… The separation of the 2 categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway” (Martin, 2002). The brain is an integrated system in which sensation and motor functions, emotions, and cognitions, are simultaneously generated.
This premise was necessary because the neuropsychiatry book edited by Yudofsky and Hales is better understood in the context of the historical evolution of psychiatry and neurology. In its fifth edition, this publication represents a further improved attestation of the editors' love for the discipline of neuropsychiatry. Merging neurologic and psychiatric aspects of mental illness using neuroscience gives the book a unique vantage point of observation toward the phenomenological manifestations of brain illness.
Yudofsky and Hales have followed several cardinal principles in the generation of the book plan.
