Talk:Neuropsychiatry

message: Done quite a big update of the article, not so much in the definition of Neuropsychiatry - that seems fine to me - but with regards to the move towards neuropsychiatry as a mainstream speciality in medicine, as opposed to a subspeciality of psychiatry. Put complete references in too, for those wishing to check statements or add more detail (e.g. year of split etc). --Neuropsychology 12:29, 6 May 2007 (UTC)
thread_title: May 2007 update

message: Looks like a fair bit of Original Research and Synthesis happening on the page. Should the article get a POV tag?--scuro 15:40, 25 October 2007 (UTC)
thread_title: OR and necessity of POV tag?

message: I removed the cleanup tag: the actual layout of the article looks somewhat tidy, except for the possible overlap between the first section, "rapprochement of neurology and psychiatry," and the third section, "summary of arguments for neuropsychiatry."  I also replaced the unreferenced tag with a 'citation style' tag, because there are several sources attributed in the article; they just don't have a uniform citation style, and they aren't wikified. Bry9000 (talk) 01:34, 9 December 2007 (UTC)
thread_title: Citations and general cleanup of this article

message: I think both the similarities and the differences have been overstated. That mental phenomena have their origin in the brain is not a discovery of the last century: it was known to Hippocrates and Galen, but oddly enough not accepted by Aristotle. Sigmund Freud, who had training in neurology as well as neuroscience, but not much in psychiatry, expressed this as "no psychosis without neurosis," by which he meant that nothing happens in the mind without first happening in the brain.
However, dealing with the same organ is not enough to allow neurology and psychiatry to be practiced together: neurosurgeons also deal with the brain, and for that matter so do psychoanalysts, counsellors, therapists of many kinds (occupational, physical, speech and language), not to mention teachers and priests. There are differences in approach, which would make it difficult to combine these professions.
On the other hand, the extent to which neurologists deal with objective pathology has possibly been overemphasised. That may be more true of neurosurgeons. Neurologists deal with large numbers of people who never have a clear diagnosis, whether or not they have physical signs, and whatever form of words may be used to placate them. Think of the people with headaches and migraine, dizzy spells or "funny turns" who throng their clinics. Recall also the "new" psychosomatic illnesses such as myalgic encephalomyelitis, fibromyalgia and chronic fatigue, which are managed by various kinds of physician rather than psychiatrists. Whereas psychiatrists no longer claim a role in the management of the "old" psychosomatic diseases (asthma, rheumatoid arthritis, ulcerative colitis, etc) now that physicians no longer run from the psychological and social aspects of disease. All medical specialties have their share of conditions where the management requires more than scientific skill.
I doubt that many doctors ever had full training in both neurology and psychiatry, as they used to be practiced in very different kinds of institution. The few psychiatric patients treated in general hospital units or outpatient clinics were not the same as those in the old mental hospitals. 
It is true that in the UK, many neurologists used to have a Diploma in Psychological Medicine (DPM), just like the psychiatrists: the examinations required two years work in psychiatric units, and asked psychiatrists to show more knowledge of neuroanatomy and neurology than is expected of them now, but the DPM faded out around 1975. The replacement, the Membership examination of the Royal College of Psychiatrists, requires three years work: which is too long away from hands-on medicine for a neurology trainee.
The Maudsley Hospital, the temple of British psychiatry, used to encourage its psychiatric trainees to get the Membership of the Royal College of Physicians before applying, but that used to be a hard slog, with not very much neurology, and may have been intended to discourage those of a psychoanalytic bent. Nowadays specialist trainees in psychiatry in the UK are much more likely to have been trained in general practice first.
The one field where neuropsychiatry is routinely practiced in the UK, but usually without the name, is the psychiatry of learning disability, known elsewhere as mental retardation, intellectual disability, etc. As well as having IQs well below average, these patients are much more likely to have mental illness, autism and epilepsy (occasionally all three). Unlike other psychiatrists, LD specialists usually manage their patients' epilepsy themselves. In keeping with their inmates' low status in society, the old institutions had few facilities, and “care in the community” has now to be practiced on a shoestring, often without access to an examination couch, let alone scans and EEGs.
However, it seems that the reasons for bringing neurology and psychiatry together are philosophical rather than practical. Medicine has never owed much to philosophy, and thousands of years of reasoning about disease and treatment got us nowhere, as did prolonged scholastic education (seven years study for a BA and MA and possibly also Holy Orders was the norm at Oxford and Cambridge before one started to study medicine, prior to the reforms of 1570) until physicians and surgeons started looking at the evidence from practice instead. NRPanikker (talk) 02:45, 8 July 2008 (UTC)
replies: text: I agree with the issue of overstating (and the section above, re possible OR/argumentation). The article seems to portray psychiatry as it was in part decades ago, psychoanalytic, blaming parents, social causes etc, rather than how it predominantly is now (based ideologically on what the APA president called the biobiobio model, related to massive pharma compnay influence). EverSince (talk) 17:42, 4 October 2008 (UTC)
thread_title:  Neurology and psychiatry 

message: I created a page on the neuropsychiatrist Fred M. Levin.  But he may not be influential in this field. Mwalla (talk) 22:57, 26 February 2009 (UTC)
thread_title:  [[Fred M. Levin]] 

message: This article has many problems, and the tag "reads like a term paper" seems appropriate...and not even a good term paper at that.  Why is there no mention of the American Neuropsychiatric Association (ANPA) in this article?  There is a link to their webpage at the bottom, of course, but no mention of the organization in the article's main body.  This is the medical specialty society for neuropsychiatry, just as we have the American Academy of Neurology, the American Psychiatric Association, or the American Academy of Pediatricians.  The fact that there is a medical subspecialty society for the field of Neuropsychiatry certainly deserves mention in the article itself...they even give out fellowships just like any other respectable society.
Also, while there are citations to the Journal of Neuropsychiatry and Clinical Neurosciences, it would be highly informative for the reader to mention that this is the official publication of ANPA (most medical societies publish their own journals).  In fact, ANPA's webpage, which is linked at the bottom of this page, states in the second paragraph, right on their front page, that The Journal of Neuropsychiatry and Clinical Neurosciences (JNP) is the official publication of the organization.  The existence of a medical society for this specialty that publishes an official journal would be one of the more pertinent pieces of information that a reader would want to find in this article, right?
ANPA's webpage goes on to mention that ANPA has taken an active role in the creation of subspecialty certification for neuropsychiatry including developing a core curriculum and setting up guidelines for training in neuropsychiatry.  As a result, Behavioral Neurology & Neuropsychiatry was approved as a subspecialty by the Unified Council for Neurologic Subspecialties (UCNS) in 2004.  I mean, this is all very pertinent information that was discovered through about 5 minutes of research from the front page of their website, easily verifiable.
Here's the basic information that I would want in an article on any medical field (with the answers in parentheses):
1.  Is there an official medical society for this specialty/subspecialty?  (yes)
2.  What is the name of this society (ANPA)
3.  When was this society founded (1988)
4.  Do they publish an academic, peer-reviewed journal (yes)
5.  Do they offer official Fellowships and CME accreditation? (yes)
6.  Is the field recogized by ABMS (if a specialty) or by an ABMS-accredited society (if a subspecialty) (yes, subspecialty recognized by UCNS, a board composed of ABMS-accredited specialty societies).
7.  Is there an official core curriculum for training in this field (yes)
From there, it might be useful to delve into the training involved, the history of the society, and the field's ties to other societies (ie APA, AAN).  Notable neuropsychiatrists might be mentioned, along with seminal publications if applicable.  ANPA's website has ample resources in this regard, as does their journal.  Obviously other sources may be useful as well.
Historical disputes between the fields of neurology and psychiatry strike me as fairly parochial (and irrelevant, given that both specialties are certified by the same ABMS board).
Unfortunately, this article needs a complete rewrite.  I'd start with the questions I've outlines above as a template.  This is an encyclopedic article, not a term paper, Op/Ed piece, or historical analysis.  Look at it from the perspective of a person who is looking up information on the subject, and start by considering the questions that they might want answered first.  Work at it from there, keep the stuff verifiable from reputable sources, and it should improve greatly.
I apologize if my comment is a bit US-specific, but I am more intimately familiar with the American medical system than those in other countries.  However, the ANPA website does also mention the International Neuropsychological Society, the British Neuropsychiatry Association, and the International Neuropsychiatry Congresses, so those organizations may also be able to provide useful information about this field in other countries. ~ Hyperion35 (talk) 14:32, 22 January 2010 (UTC)
replies: text: Hyperion, all fair comments. Wikipedia encourages users to be bold, so if you have an interest in this area you are a suitable candidate to edit the page! I too have an interest (and am a member of the BNPA) but sadly I don't have as much knowledge in this area. All the best, --PaulWicks (talk) 01:52, 23 January 2010 (UTC)
thread_title:  Why no mention of ANPA? 

message: I wish to observe that the table named "Linking traditionally psychiatric symptoms to brain structures and genetic abnormalities" is not only totally outdated, but also factually inaccurate, especially since the title is talking about symptoms, but in the table one does not see any symptoms, but rather diseases being presented. 
Please see the wikipedia own definition of symptoms, syndromes, and diseases: 
http://en.wikipedia.org/wiki/Symptoms
http://en.wikipedia.org/wiki/Syndrome
http://en.wikipedia.org/wiki/Disease
I do not wish to enter into the details of the poorly supported blatant inaccuracies of the psychoanalytic interpretation of various psychiatric disorders listed in that table. 
In my opinion that table does a great disservice to the entire article, which is otherwise written quite well, and contributes in an obviously painful way to the diminuation of the credibility of the entire article, which is sad, given the wonderful and exciting advances that are being made each day in the study of the field of consciousness and the rich scientific literature that already exists. 
Please, please, just scrap that table altogether !
Rudolph Aspirant (aka Eugen Craciun),
10th August, 2011
17:09, Oslo
84.210.21.34 (talk) 15:09, 10 August 2011 (UTC)
replies: text: Well, I disagree with you about the overall quality of the article, but I tend to agree with you about the table.  I'll leave it for the moment though in case anybody else wants to comment. Looie496 (talk) 15:26, 10 August 2011 (UTC)

text: Agree that the table is awful and POV. It makes psychiatry look ridiculous with strange psychodynamic approaches being compared with neurology, rather than current psychiatric approaches. Secretlondon (talk) 18:51, 21 May 2016 (UTC)
thread_title:  Please edit this 

message: This article reads like a history of a specific part of the neurology/psychiatry borderline rather than an article about the modern medical field of neuropsychiatry.  The introduction and the (short) very last section talk about the modern medical field, but the rest of the article is about historical and philosophical differences between neurology and psychiatry.  In short, if somebody is looking to Wikipedia to understand the job of a neuropsychiatrist, this article will be useless in answering that question.
I can think of a few different options for cleaning up the article:
* Reduce the size of the history section in comparison with sections about the medical field.
* Place much of the history/philosophy in a different article and link to that article.
* Provide more details about the role of modern neuropsychiatrists in medical treatment.
* Explain a bit of the distinction between neuropsychiatrists and neuropsychologists.
Thoughts? Techielaw (talk) 16:44, 4 January 2015 (UTC)
replies: text: I think your critique and suggested solutions are great overall. I encourage you to improve the coverage however you're able. I wish I could offer help, but like most people, as someone who doesn't work in any of the fields, I don't know enough about the fields' details to take the next steps that you identify. And actually, that's the explanation of how gaps like this arise in many Wikipedia articles. The content and its gaps, to date, reflect the contributorship and its gaps, to date. It takes a new and more knowledgeable addition to the contributorship (such as you, in the post above) to move to the next level of coverage quality. My only caveat about the suggested improvements is that it's usually best not to wipe out any valid info that has already been contributed, even if it is out of proportion because the other areas are underdeveloped. Instead, preserve that info but relegate it to a section or to a separate article. If the size of the section just bugs you, better to move it to a separate article than to delete it. One of the reasons this is important is that it prevents dysfunction and atrophy of the contributor community, which threatens the health of the project (the whole encyclopedia as an ongoing project that relies on continual volunteer efforts). By refraining from wiping out the useful contributions of whichever few people wrote that portion of coverage, it avoids causing worthwhile contributors from thinking, "Well, they deleted most of the valid writing that I worked on, so screw it, Wikipedia can rot without me from now on." Anyhow, if you get any time, I encourage you to make the improvements that you are able to make. Regards, — ¾-10 18:08, 4 January 2015 (UTC)
replies: text:  Are there Wikipedia guidelines on how to move the history/philosophy section elsewhere?  What would that article be named?  On related note, there's also a Wikipedia page about Behavioral_neurology.  The name of the medical subspeciality is "Behavioral Neurology & Neuropsychiatry."  Perhaps there should be one article with that name and another article about the history/philosophy? Techielaw (talk) 11:43, 30 June 2015 (UTC)
thread_title:  Too little about the field of neuropsychiatry, too much about history/philosophy 

message: I found this and it might be useful Royal College of Psychiatry neuropsychiatry reading list Secretlondon (talk) 19:34, 26 May 2016 (UTC)
thread_title:  neuropsychiatry reading list 

message: Psychiatry does not look "outside the skin".  It is based on the hypothesis of neurotransmitters for which no drug as ever been proven to correct  — Preceding unsigned comment added by 208.89.33.72 (talk) 20:16, 16 July 2016 (UTC)
thread_title:  Psychiatry