Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward

Schildkrout, Barbara; Benjamin, Sheldon; Lauterbach, Margo D.

doi:10.1097/acm.0000000000001003

Cited by 24 publications

(22 citation statements)

References 42 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Psychiatry as a clinical neuroscience specialty must be better integrated with the rest of medicine, 197,198 and catatonia is a chief case-study in the argument. It is imperative that clinicians across many disciplines improve recognition and diagnosis of catatonia.…”

Section: Discussionmentioning

confidence: 99%

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

Lloyd¹,

Silverman²,

Kugler³

et al. 2020

NDT

View full text Add to dashboard Cite

Catatonia is a serious, common syndrome of motoric and behavioral dysfunction, which carries high morbidity and mortality. Electroconvulsive therapy (ECT) is the definitive treatment for catatonia, but access to ECT for the treatment of catatonia remains inappropriately limited. Catatonia is observable, detectable, and relevant to various medical specialties, but underdiagnosis impedes the delivery of appropriate treatment and heightens risk of serious complications including iatrogenesis. Current understanding of catatonia's pathophysiology links it to the current understanding of ECT's mechanism of action. Definitive catatonia care requires recognition of the syndrome, workup to identify and treat the underlying cause, and effective management including appropriate referral for ECT. Even when all of these conditions are met, and despite well-established data on the safety and efficacy of ECT, stigma surrounding ECT and legal restrictions for its use in catatonia are additional critical barriers. Addressing the underdiagnosis of catatonia and barriers to its treatment with ECT is vital to improving outcomes for patients. While no standardized protocols for treatment of catatonia with ECT exist, a large body of research guides evidence-based care and reveals where additional research is warranted. The authors conducted a review of the literature on ECT as a treatment for catatonia. Based on the review, the authors offer strategies and future directions for improving access to ECT for patients with catatonia, and propose an algorithm for the treatment of catatonia with ECT.

show abstract

Section: Discussionmentioning

confidence: 99%

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

Lloyd¹,

Silverman²,

Kugler³

et al. 2020

NDT

View full text Add to dashboard Cite

show abstract

“…However, owing to lack of direct personal experience of laboratory work, the language and methods used are daunting for many clinicians. This potentially leaves relevant pathophysiological work impenetrable and clinicians may be less able to read and critically appraise neuroscientific research that could contribute to their understanding of their patients' presentations (Schildkrout 2016). The Royal College of Psychiatrists' Neuroscience Project, funded by the Gatsby Foundation and Wellcome Trust, aims to integrate modern neuroscience into the psychiatry curriculum (https://www.rcpsych.ac.uk/training/neurosciencein-training/neuroscience).…”

Section: Introductionmentioning

confidence: 99%

Demystifying neuroscience laboratory techniques used to investigate single-gene disorders

Mizen¹,

Stanfield²

2020

BJPsych advances

View full text Add to dashboard Cite

SUMMARY There is considerable work being carried out in neuroscientific laboratories to delineate the mechanisms underlying single-gene disorders, particularly those related to intellectual disability and autism spectrum disorder. Many clinicians will have little if any direct experience of this type of work and so find the procedures and terminology difficult to understand. This article describes some of the laboratory techniques used and their increasing relevance to clinical practice. It is pitched for clinicians with little or no laboratory science background.

show abstract

“…However, the neurology experience is not nationally standardized in content or in measurement of educational outcomes [21]. There is significant variability in the setting, intensity, and content of the clinical neurology experience.…”

Section: Lack Of Standardization In Clinical and Didacticmentioning

confidence: 99%

Neurology Training for Psychiatry Residents: Practices, Challenges, and Opportunities

Shalev

Jacoby

2018

Acad Psychiatry

View full text Add to dashboard Cite

Historically, neurology, psychiatry, and neuroscience overlapped; it is only recently that disciplinary silos have divided these fields. In the eighteenth and nineteenth century, many significant figures in neurology and psychiatry, including Freud, Charcot, Alzheimer, and Kraepelin, emerged from a shared epistemological background [1]. In the early twentieth century, a period of rapid medical specialization, most physicians in these fields enjoyed board certification in both specialties [2]. However, in the second half of the twentieth century, training pathways for neurology and psychiatry diverged [1]. By the 1980s, there was little emphasis on cross-training between neurology and psychiatry [2].Over the past three decades, there has been an increase in residency training emphasis on neuroscience, "a broad discipline encompassing the study of the nervous system and behavior using cellular and molecular biology, animal models, neuroanatomy, neuroimaging, genetics, neuropsychology, and basic pharmacology (as opposed to clinical pharmacology)" [3]. Since 2006, there has been a boom in neuroscience education with the rapidly developing National Neuroscience Curriculum Initiative [4], but the challenge of clinical application remains [5].Neuroscience, neuropsychiatry, and neurology are distinct entities [3,5,6]. Neuroscience in psychiatry involves understanding psychiatric illness through the lens of neuroscientific knowledge ranging from functional anatomy to genomics; examples include microstructural neurodevelopmental aspects of schizophrenia and the neurobiology of suicide. Neurology and neuropsychiatry are fundamentally clinical. Neurology refers to the care of patients with disease of the brain, spinal cord, and peripheral nerves. Neuropsychiatry refers to the care of patients with affective, behavioral, and cognitive symptoms in the setting of neurologic disorders such as stroke or epilepsy, as well as to the care of patients with psychiatric illness that have comorbid or iatrogenic neurologic symptoms [5].Neurology and neuropsychiatry training for psychiatry residents is not yet standardized. In this article, we critically review the current state of neurology and neuropsychiatry training for psychiatric residents: we explicitly consider the goals of such training, identify the gaps in training and the barriers to achieving these goals, and present suggestions for improving the neurology and neuropsychiatry training of psychiatrists. The State of Neurology Training and Evaluation for Psychiatry ResidentsSince 1987, psychiatry trainees have been mandated by the Accreditation Council for Graduate Medical Education (ACGME) and American Board of Psychiatry and Neurology (ABPN) to complete two months of full-time clinical neurology training [7]. The ACGME does not have guidelines for the neurology off-service rotation months with respect to clinical setting or didactic content [6].There are no formal clinical requirements for neurology or neuropsychiatry beyond the two-month requirement. In a 2011-2012 survey o...

show abstract

Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward

Cited by 24 publications

References 42 publications

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

Demystifying neuroscience laboratory techniques used to investigate single-gene disorders

Neurology Training for Psychiatry Residents: Practices, Challenges, and Opportunities

Contact Info

Product

Resources

About