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December 4, 2002

NeuropsychiatryThe American Psychiatric Publishing Textbook of Neuropsychiatry and Clinical Neurosciences

Author Affiliations

Harriet S.MeyerMD, Contributing EditorDavid H.MorseMS, Journal Review EditorRobertHoganMD, adviser for new media


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JAMA. 2002;288(21):2750-2751. doi:10.1001/jama.288.21.2750-JBK1204-3-1

The significance of brain dysfunction in psychiatric conditions is exemplified by contemporary neuropsychiatry, a psychiatric subspecialty concerned with psychiatric disturbances in patients with known central nervous system disorders or dysfunction. In Parkinson disease, for instance, mood, behavioral, and cognitive changes figure prominently, are related to the underlying disease processes, and overlap with the primary motor features. They are also a major source of untreated morbidity. It is therefore essential that all practitioners take an integrative approach to patient management and inquire about psychiatric symptoms as often as they ask about tremor. Likewise, it is critical that public policies acknowledge the interface of psychiatry and neurology in brain-based disorders and resolve disparate access to psychiatric care, as in the absurd and dangerous predicament faced by the family of a patient with Parkinson disease, psychosis, and severe agitation whose medical insurance plan would not authorize inpatient psychiatric treatment. The neuropsychiatric perspective thus links the fields of neurology and psychiatry by encouraging consideration of all neurological and psychiatric disorders beyond their respective physical signs and mental aberrations and how they are interrelated through patterns of brain dysfunction.

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