What Is a Psychiatric Neurologist?

Neuropsychiatry blends the closely related specialties of neurology and psychiatry. It is a field of medical practice born from the acknowledgment that mental illness and neurological disorders often go hand-in-hand, requiring comprehensive treatment that addresses the physical and psychological components of an illness. Psychiatric neurologists, or neuropsychiatrists, as they are more commonly called, practice this subspecialty of psychiatry with a focus on the brain-behavioral connection.

History of Neuropsychiatry

• Before the 1950s, psychiatry relied upon psychoanalysis as the main form of treatment. But when antidepressants and other medications were introduced a half-century ago as viable treatment options, it became apparent that mental illnesses could have a physiologic component as well. As more was learned about the etiology of psychiatric disorders, the need for a new breed of medical practitioner became apparent. Hence, the psychiatric subspecialty of neuropsychiatry was established.

Types of Neuropsychiatrists

• Clinical neuropsychiatrists are trained, licensed physicians who have earned a doctorate in psychology. They have likewise completed all the necessary training in the field of neurology. Like other physicians, they typically work in hospitals or private practice.

  Some neuropsychiatrists work in the field of experimental neuropsychology as researchers, studying the relationship between the mind and brain. These neuropsychiatrists typically do not practice medicine.

  Cognitive neuropsychiatrists study normal body and mind functions in order to understand and identify impairments. This field is only about 20 years old, but has already been useful by shedding light on some previously unexplained disorders.

Argument for the Need for Neuropsychiatric Specialty

• Most scientists assert that mental illness is like any other kind of illness, manifesting from internal and external factors--or both. They reject the idea that disorders of the brain and mind are primarily separate. In other words, mental illness can be a biological disorder, and practitioners should seek to relieve symptoms through a combination of medications and other medical interventions, as well as psychotherapy. This approach underscores the need for a specialist who can provide a mixture of psychiatric and neurological treatment. Increasingly, research is strengthening this argument by demonstrating an organic etiology for many psychological disorders.

Arguments Against the Need for Neuropsychiatric Specialty

• The most widespread argument being waged on the medical front upholds a traditional school of thought that says diseases of the mind and brain must be considered separately. While psychology and neurology involve the same body system, some scientists assert that the mind and brain are too different to be addressed together. Others go as far as to say that it is impossible to effectively practice both psychiatry and neurology, that the nature of each is too different to incorporate into a single specialty.

  Another argument against the practice involves the limitations of current research. Scientists still have not been able to fully "map" mental syndromes in the brain or genome. This leads some critics to charge that psychological disorders should not yet be coupled with the more fully understood diseases of neurology. The complexity of mental disorders and the intricacies of brain organics are cited by many researchers as a major hurdle in the mapping process. Still, scientists are hopeful that breakthroughs can eventually be made.

Future of Neuropsychologists

• Despite current controversies, neuropsychiatrists aren't likely to disappear any time soon. Their expertise affords them many opportunities for conducting important research in addition to providing treatment for patients presenting with neuropsychological problems.

  The field of forensics also offers exciting options for the neuropsychiatrist. They are often recruited as expert witnesses, to provide patient assessments and treatments, and to work with offenders. They are often needed, as well, to help direct clinical trials for pharmaceutical companies that are developing medications to treat psycho-neurological disorders.