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INTRODUCTION

Our textbook has evaluated advances in basic and clinical neuroscience and presented an integrated view of neuropsychiatry and behavioral neurology, with the ultimate goal of improving the care and reducing the suffering of those affected by neuropsychiatric disorders. Knowledge, practices, disciplines, and nosology involving the fields related to clinical neuroscience have undergone many iterations and classifications over the years. One important iteration has been the division of neurology and psychiatry into two separate disciplines that pay attention to different phenomena, pathogenic mechanisms, and treatment methods.1,2 Table 39-1 provides an illustration of these differences, using a patient with multiple sclerosis and depression as an example. In other iterations of clinical neuroscience, the borders between fields are less distinct and there has been considerable overlap between psychiatry and neurology. For decades, researchers and clinicians have discussed intersection and commonalities between these fields. For centuries, philosophers have discussed the relationship between brain and mind, feelings and intellect, subjective experience and behavior.3–5 The experience of patients is in agreement with an integrated view of neurology and psychiatry: Individuals with brain illness often suffer from combinations of motor, sensorial, autonomic, emotional, behavioral, and cognitive symptoms. It is not their priority to know which discipline “owns” their illness or their symptoms, other than to find appropriate care.

TABLE 39-1Neurology and Psychiatry as Different Disciplines *.

Neurology has long established itself as the medical specialty that contends with diseases of the nervous system, with cognitive and behavioral neurology as the subspecialty that focuses on the functional neurocircuitry of cognition and the ways in which to treat cognitive and behavioral manifestations of central nervous system disorders. Psychiatry has been a medical specialty with different orientations developing in parallel over time (see Table 39-2). In general, psychiatry has sustained a more integrative or bio-psycho-social view of human behavior. Neuropsychiatry focuses on a brain circuit-based understanding of disorders of emotion and behavior—including the neurological underpinnings of “psychiatric” conditions and the “psychiatric” aspects of “neurologic” conditions. A ...

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