The return of neuropsychiatry: why clinical neuroscience needs neurology and psychiatry reunited

Abstract

The distinction between neurology and psychiatry is so deeply ingrained that it is sometimes assumed to represent a fundamental truth about the organisation of brain diseases, their diagnosis and treatment 1,2. Patients with Parkinson’s disease see neurologists; patients with depression are referred to psychiatrists. One group is perceived to treat disorders of the brain, the other disorders of the mind. Medical schools maintain separate curricula, hospitals separate departments, funding agencies separate review panels, and specialist societies separate annual meetings. Insights into the semiology and pathophysiology of disorders of the central nervous system gained over the past 40 years warrant a reconsideration of this dichotomic approach to clinical neuroscience, not least because conditions that were once considered prototypical neurological disorders, such as Parkinson’s disease, have since been demonstrated also to encompass many psychiatric comorbid elements 3.