ARTICLE NEUROPSYCHAITRIC DEFINITIONS, CONCEPTS, AND PATIENT TYPES

neuropsychiatry

integrative medical specialty where neurology and neuroscience are helpful for understanding mental and ebhavioural illness; combines psychiatry, neurology and neuropsychology

explain the 1800s of neuropsychiatry

brain’s role in mental life and illness was acknowledged, but the precise nature of brain-mind relationship remains a subject on ongoing debate

explain the 19th century of neuropsychiatry

distinction between neurologists and psychiatrists was more about practice settings than fundamental approaches

there were many pioneers in the neuropsychiatric matrix. Name the 4

Franz Nissl, Auguste Forel, Alois Alzheimer, Sigmund FreudFr

Franz Nissl

developed a technique that transformed neuroanatomy

Auguste Forel

identified the forel fields near the thalamus, now targeted in DBT for Tourette Syndrome

Alois Alzheimer;

identified brain changes associated with AD

Sigmund Freud

influenced theories of brain function, htough he later shifted focus to the psychological mind

Neuropsychiatry focuses on how brain function relates to psychiatric symptoms, but it recognizes both its strengths and limitations. Name 2 limitations

1) It doesn’t claim that all mental illnesses are caused by the brain problems
2) Determining what causes a mental illness is complicated. Just because a brain lesion can lead to a symptoms, doesn’t mean that all similar symptoms come from the same type of brain damage

Name the five neuropsychiatric patient types

type 1: bheaivoural neurology model

type 2: neurology as a meme

type 3: interactive model

type 4: neuropsychiatry of pain and ANS

type 5: neuropsychiatry of psychotropic drug use

explain type 1 patient type (behavioural neurology model)

neuropahtology is seen as both the necessary and sufficient cause of neuropsychiatric disorders

→ understanding the brain damage is essential. We can often connect specific brain changes to specific mental symptoms in a one way direction

explain type 2 patient type (neurology as a meme)

neurological symptoms come from psychological distress (functional neurological disorders). Psychological factors often play a major role and there is no clear brain abnormality found.
Symptoms look like real neurological problems but don’t follow the usual ruels of brain function (phenocopies)

How was functional neurologic disorder called first?

Hysteria

explain type 3 patient type (interactive model)

Neuropahtology is necessary but not sufficient. THere is a mix of established neurological conditions and psychiatric illnesses with no clear physical cause.
They interact in two ways: cross-sectional and longitudinal

explain type 4 patient type (neuropsychiatry of pain and ANS

Many psychological well-being issues oriignate in the PNS and ANS.
→ they are connected to higher brain circuits, allowing for ocnsoldiation, learning, memory and sensitization of circuits. This can stay active even without initial trigger

Pain is different from nociception, as it’s processed at different levels of the brain. The limbic system plays a key role in chornic pain and suffering.

ANS is involved inv arious medical and neurological conditions and affects emotional expresson.
→ hypothalamus influences both the parasympathetic and sympathetic nervous systems, impacting multiple organs and possibly contributing to conditions like takotsubo cardiomyopathy

explain type 5 patient type (neuropsychiatry as psychotropic drug use)

psychopharmacology is closely tied to neuropsychiatry because psychotropic effects are driven by neurological mechanisms.
1) psychotropic drugs have strong neurological effects

2) they’ve non-psychotropic drugs

3) clinical effects aren’t just due to direct neurotransmitter actions

neuroscience

viewing illness as a failure of neuroplasticity and a restriction of options, where symptoms like perseveration reflect an inability to adapt

What is neuroanatomy important for

for formulating and treating neuropsychiatric patients

Give four examples of neuroanatomy

1) quasi-hierarchical organization of the brain

2) large scale networks: brain function is determiend by its connections, intially shown with parallel distributed processing models

3) re-entrant loops: linking cortex, basal ganglia and thalamus, modulating motor, cogntive and emotional functions

4) consensus networks: default mode network (internally directed cogniton), central executive network (externally) and salience network (switching, also with social behaviour and self-awareness)