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Mark I, Poole N, Agrawal N. Integration of neuroscience into psychiatric training and practice: suggestions for implementation. BJPsych Bull 2024:1-7. [PMID: 38679951 DOI: 10.1192/bjb.2024.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Mainstream psychiatric practice requires a solid grounding in neuroscience, an important part of the biopsychosocial model, allowing for holistic person-centred care. There have been repeated calls for better integration of neuroscience into training, although so far with less focus on implementation for life-long learning. We suggest that such training should be accessible and utilised by all psychiatrists, not solely those with a special interest in neuropsychiatry. By considering recent positive developments within the general psychiatry curricula and neuropsychiatric resource implementation, we propose strategies for how this can be progressed, minimising regional disparities within the growing world of virtual learning.
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Affiliation(s)
- Isabel Mark
- South West London and St George's Mental Health NHS Trust, London, UK
- St George's University of London, London, UK
| | - Norman Poole
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Niruj Agrawal
- South West London and St George's Mental Health NHS Trust, London, UK
- St George's University of London, London, UK
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Nasrallah HA, Keshavan M. Controversies and knowledge expansion in psychiatry. Asian J Psychiatr 2023; 82:103535. [PMID: 36948919 DOI: 10.1016/j.ajp.2023.103535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- Henry A Nasrallah
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
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3
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Gauld C, Micoulaud-Franchi JA, Dumas G. Comment on Starke et al.: 'Computing schizophrenia: ethical challenges for machine learning in psychiatry': from machine learning to student learning: pedagogical challenges for psychiatry. Psychol Med 2021; 51:2509-2511. [PMID: 33087200 DOI: 10.1017/s0033291720003906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000Grenoble, France
- UMR CNRS 8590 IHPST, Sorbonne University, Paris1, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076Bordeaux, France
- USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Guillaume Dumas
- Precision Psychiatry and Social Physiology Laboratory, CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Quebec, Canada
- Human Brain and Behavior Laboratory, Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, Florida, USA
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Hernandez CR, Camp MME. Current Educational Practices for Major Neurocognitive Disorders in Psychiatry: a Scoping Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:451-459. [PMID: 33686538 DOI: 10.1007/s40596-021-01424-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE A scoping review of the literature was performed to examine the current state of education on major neurocognitive disorders within psychiatry, to review influential factors for pursuing a career working with these patients, and to review what has been done in education to address the shortage of providers to care for patients with major neurocognitive disorders. METHODS Using the Arksey and O'Malley framework for conducting scoping reviews, twenty-eight studies on education in geriatric psychiatry, neuropsychiatry, and major neurocognitive disorders were selected. Learner groups included medical students, residents, and psychiatrists. The results from the studies were compared, and major themes were presented. RESULTS Several studies found that positive clinical experiences with older adult patients and effective teachers in geriatric psychiatry play a role in influencing trainees to pursue a career in geriatric psychiatry. Topics pertaining to major neurocognitive disorders are taught by the majority of medical schools during the psychiatry rotation and are rated as the most important teaching topic in neurology among psychiatry residency program directors. Several interventions have resulted in increased comfort working with geriatric patients and patients who have major neurocognitive disorders among students, but fewer studies have resulted in an increase in interest seeing these patients in practice. There is a lack of research pertaining to psychiatry residents working with patients that have major neurocognitive disorders. CONCLUSIONS While research on geriatric psychiatry and neuropsychiatry education exists, more research is needed that focuses specifically on how medical students and psychiatry residents are being taught major neurocognitive disorders.
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Neuroscience Education: Making It Relevant to Psychiatric Training. Psychiatr Clin North Am 2021; 44:295-307. [PMID: 34049650 DOI: 10.1016/j.psc.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Psychiatric education has struggled to move past dualistic notions separating mind from brain, and embrace the field's identity as a clinical neuroscience discipline. To modernize our educational systems, we must integrate neuroscience perspectives into every facet of our clinical work. To do this effectively, neuroscience education should be clinically relevant, informed by adult learning theory, and tailored to the individualized needs of learners. Classic neuropsychiatry skills can help us better understand our patients' brain function at the bedside. Integrating neuroscience perspectives alongside the other rich perspectives in psychiatry will help trainees appreciate the relevance of neuroscience to modern medical practice.
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Keshavan MS, Price BH, Martin JB. The Convergence of Neurology and Psychiatry: The Importance of Cross-Disciplinary Education. JAMA 2020; 324:554-555. [PMID: 32163095 DOI: 10.1001/jama.2020.0062] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Bruce H Price
- McLean Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Hassan T, Prasad B, Meek BP, Modirrousta M. Attitudes of Psychiatry Residents in Canadian Universities toward Neuroscience and Its Implication in Psychiatric Practice. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:174-183. [PMID: 31648547 PMCID: PMC7019466 DOI: 10.1177/0706743719881539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Despite recent advances in neuroscience highlighting its potential applications in the assessment and treatment of psychiatric disorders, the training of psychiatrists in neuroscience is lacking. However, it is not clear to what extent Canadian trainees are interested in further learning and using neuroscience in their daily clinical practice. This study explored the attitudes of Canadian psychiatry trainees with regard to neuroscience education and training by asking them to assess their own understanding of neuroscience and the perceived relevance of neuroscience knowledge to effective psychiatric practice. METHODS An online questionnaire was sent to psychiatry residents at Canadian universities. This questionnaire consisted of self-assessments of neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interest in specific neuroscience topics. RESULTS One hundred and eleven psychiatry residents from psychiatry residency programs at Canadian universities responded to this survey. Participants represented trainees from all 5 years of residency. Almost half of all trainees (49.0%) reported their knowledge of neuroscience to be either "inadequate" or "less than adequate," and only 14.7% of trainees reported that they feel "comfortable" or "very comfortable" discussing neuroscience findings with their patients. 63.7% of Canadian trainees rated the quantity of neuroscience education in their residency program as either less than adequate or inadequate, and 46.1% rated the quality of their neuroscience education as "poor" or "very poor." The vast majority of participants (>70%) felt that additional neuroscience education would be moderately-to-hugely helpful in finding personalized treatments, discovering future treatments, destigmatizing patients with psychiatric illness, and understanding mental illness. CONCLUSIONS Canadian trainees generally feel that their neuroscience knowledge and the neuroscience education they receive during their psychiatry residencies is inadequate. However, as the first step for any change, the majority of future Canadian psychiatrists are very motivated and have a positive attitude toward neuroscience learning.
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Affiliation(s)
- Taghreed Hassan
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin Prasad
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin P Meek
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mandana Modirrousta
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
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Manning KJ, Gunning FM, Aizenstein HJ, Steffens DC. Training the Next Generation of Geriatric-Focused Clinical Neuroscientists. Am J Geriatr Psychiatry 2019; 27:720-727. [PMID: 30928155 DOI: 10.1016/j.jagp.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/26/2019] [Accepted: 03/07/2019] [Indexed: 01/21/2023]
Abstract
It remains challenging to integrate clinical neuroscience into clinical practice. Hindrances at the training level (e.g., lack of qualified faculty and curriculum) contribute to this impasse. To help address this, we present a model of training in clinical neuroscience. We expand on a growing literature on incorporating neuroscience into psychiatry training by emphasizing two points. That is, 1) we propose a training model designed for the geriatric-minded clinician; and 2) that extends across several phases of education and career development. Considering the relevance of dementia to our population of interest, and the potential impact expertise in clinical neuroscience can have in elders with cognitive impairment, we provide relevant curriculum examples at various training stages. Clinical research, both as a practitioner and consumer, figures prominently into our training model. We discuss two mentoring programs, T32 fellowships and Research Career Institute in the Mental Health of Aging, as ways to engage geriatric psychiatrists early in their training and transition them successfully to post-residency clinical investigator positions. Although there is increasing opportunity for geriatric psychiatrists and other clinicians to become leaders in the field of neuroscience, this remains a work in progress; ours and others' training programs continue to evolve based on input from trainers and trainees alike, as well as from the increasing literature on this important topic.
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Affiliation(s)
- Kevin J Manning
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT.
| | - Faith M Gunning
- Department of Psychiatry (FMG), Weill Cornell Medical College, White Plains, NY
| | | | - David C Steffens
- Department of Psychiatry (KJM, DCS), University of Connecticut Health Center, Farmington, CT
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Shalev D, Jacoby N. Neurology Training for Psychiatry Residents: Practices, Challenges, and Opportunities. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:89-95. [PMID: 29777396 DOI: 10.1007/s40596-018-0932-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 04/30/2018] [Indexed: 05/23/2023]
Affiliation(s)
- Daniel Shalev
- Columbia University Medical Center, New York, NY, USA.
| | - Nuri Jacoby
- Maimonides Medical Center, Brooklyn, NY, USA
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11
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Cooper JJ, Korb AS, Akil M. Bringing Neuroscience to the Bedside. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2019; 17:2-7. [PMID: 31975952 DOI: 10.1176/appi.focus.20180033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Clinical psychiatry has not historically expected practitioners to learn the basic science of psychiatric illness. Despite wide recognition that all effective psychiatric treatments have neurophysiological mechanisms, the field has struggled to integrate concepts of the mind and brain. Because of historical separations of clinical psychiatry and evolving neuroscience research, many psychiatric residency programs feel underresourced to teach clinically relevant neuroscience, and current residency graduates are not being prepared to integrate neuroscience findings into their practice. Significant strides have been made in the understanding of the neurobiology of psychiatric disorders. Similarly, the neurobiological mechanisms of a wide variety of treatments have been elucidated, spanning interventions from psychotherapy to physical exercise, electroconvulsive therapy, and modern neuromodulation techniques. The authors discuss strategies for integrating the language of clinical neuroscience into everyday psychiatric practice and review resources available to clinicians and trainees to help them acquire and practice these skills.
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Affiliation(s)
- Joseph J Cooper
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
| | - Alexander S Korb
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
| | - Mayada Akil
- Department of Psychiatry, University of Illinois at Chicago (Cooper); Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Korb); Department of Psychiatry, MedStar Georgetown University Hospital, Washington, D.C. (Akil)
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Narasimha VL, Basavaraju R, Mangalore S, Mehta UM. Precuneus and psychiatric manifestations: Novel neurobiological formulations through lesion based connectivity mapping of psychopathology. Asian J Psychiatr 2019; 39:98-100. [PMID: 30599452 DOI: 10.1016/j.ajp.2018.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/25/2018] [Accepted: 12/26/2018] [Indexed: 01/02/2023]
Abstract
Lesion-based investigations of psychopathology have preceded contemporary network-neuroscience initiatives. However, brain-lesions detected in routine psychiatric practice are often considered incidental and therefore ignored. Here, we illustrate a strategy to combine individual subject-level lesion information with open-source normative functional-connectomics data to make putative, neuroscience-informed symptom interpretation. Specifically, we report a patient with left precuneus granulomatous lesion and seizures followed by two distinct symptoms - kinetopsia and delusions of nihilism and guilt - which had a differential treatment response. The lesion-based brain-mapping approach could identify correlated (default-mode) and anti-correlated (temporo-parieto-occipital) networks, which enabled a neurobiological formulation of these diverse clinical manifestations.
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Affiliation(s)
- Venkata Lakshmi Narasimha
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, Karnataka, India
| | - Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, Karnataka, India
| | - Sandhya Mangalore
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, Karnataka, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, Karnataka, India.
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Perez DL, Keshavan MS, Scharf JM, Boes AD, Price BH. Bridging the Great Divide: What Can Neurology Learn From Psychiatry? J Neuropsychiatry Clin Neurosci 2018; 30:271-278. [PMID: 29939105 PMCID: PMC6309772 DOI: 10.1176/appi.neuropsych.17100200] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Neurology and psychiatry share common historical origins and rely on similar tools to study brain disorders. Yet the practical integration of medical and scientific approaches across these clinical neurosciences remains elusive. Although much has been written about the need to incorporate emerging systems-level, cellular-molecular, and genetic-epigenetic advances into a science of mind for psychiatric disorders, less attention has been given to applying clinical neuroscience principles to conceptualize neurologic conditions with an integrated neurobio-psycho-social approach. In this perspective article, the authors briefly outline the historically interwoven and complicated relationship between neurology and psychiatry. Through a series of vignettes, the authors then illustrate how some traditional psychiatric conditions are being reconceptualized in part as disorders of neurodevelopment and awareness. They emphasize the intersection of neurology and psychiatry by highlighting conditions that cut across traditional diagnostic boundaries. The authors argue that the divide between neurology and psychiatry can be narrowed by moving from lesion-based toward circuit-based understandings of neuropsychiatric disorders, from unidirectional toward bidirectional models of brain-behavior relationships, from exclusive reliance on categorical diagnoses toward transdiagnostic dimensional perspectives, and from silo-based research and treatments toward interdisciplinary approaches. The time is ripe for neurologists and psychiatrists to implement an integrated clinical neuroscience approach to the assessment and management of brain disorders. The subspecialty of behavioral neurology & neuropsychiatry is poised to lead the next generation of clinicians to merge brain science with psychological and social-cultural factors. These efforts will catalyze translational research, revitalize training programs, and advance the development of impactful patient-centered treatments.
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Affiliation(s)
- David L. Perez
- Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Neuropsychiatry Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jeremiah M. Scharf
- Movement Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Brigham and Women’s Hospital, Boston, MA
| | - Aaron D. Boes
- Departments of Pediatrics, Neurology and Psychiatry, University of Iowa Health Care, Carver College of Medicine, Iowa City, IA
| | - Bruce H. Price
- Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Neurology, McLean Hospital, Harvard Medical School, Belmont, MA
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The Inpatient Assessment and Management of Motor Functional Neurological Disorders: An Interdisciplinary Perspective. PSYCHOSOMATICS 2018; 59:358-368. [PMID: 29628294 DOI: 10.1016/j.psym.2017.12.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/22/2017] [Accepted: 12/26/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Motor functional neurologic disorders (FND)-previously termed "hysteria" and later "conversion disorder"-are exceedingly common and frequently encountered in the acute hospital setting. Despite their high prevalence, patients with motor FND can be challenging to diagnose accurately and manage effectively. To date, there is limited guidance on the inpatient approach to the neuropsychiatric evaluation of patients with functional (psychogenic) neurologic symptoms. OBJECTIVE The authors outline an inpatient multidisciplinary approach, involving neurology, psychiatry, and physical therapy, for the assessment and acute inpatient management of motor FND. METHODS A vignette of a patient with motor FND is presented followed by a discussion of general assessment principles. Thereafter, a detailed description of the neurologic and psychiatric assessments is outlined. Delivery of a "rule-in" diagnosis is emphasized and specific guidance for what can be accomplished postdiagnosis in the hospital is suggested. DISCUSSION We encourage an interdisciplinary approach beginning at the early stages of the diagnostic assessment once an individual is suspected of having motor FND. CONCLUSIONS Practical suggestions for the inpatient assessment of motor FND are presented. It is also important to individualize the diagnostic assessment. Future research should be conducted to test best practices for motor FND management in the acute inpatient hospital setting.
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Sakurai T. Circuitry-Based Human Neuroanatomy for the Next Generation in Psychiatry and Neuroscience. MOLECULAR NEUROPSYCHIATRY 2017; 3:92-96. [PMID: 29230397 DOI: 10.1159/000479514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/14/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Takeshi Sakurai
- Department of Drug Discovery Medicine, Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
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16
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Abstract
Abstract:Diagnostic classification systems in psychiatry have continued to rely on clinical phenomenology, despite limitations inherent in that approach. In view of these limitations and recent progress in neuroscience, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project to develop a more neuroscientifically based system of characterizing and classifying psychiatric disorders. The RDoC initiative aims to transform psychiatry into an integrative science of psychopathology in which mental illnesses will be defined as involving putative dysfunctions in neural nodes and networks. However, conceptual, methodological, neuroethical, and social issues inherent in and/or derived from the use of RDoC need to be addressed before any attempt is made to implement their use in clinical psychiatry. This article describes current progress in RDoC; defines key technical, neuroethical, and social issues generated by RDoC adoption and use; and posits key questions that must be addressed and resolved if RDoC are to be employed for psychiatric diagnoses and therapeutics. Specifically, we posit that objectivization of complex mental phenomena may raise ethical questions about autonomy, the value of subjective experience, what constitutes normality, what constitutes a disorder, and what represents a treatment, enablement, and/or enhancement. Ethical issues may also arise from the (mis)use of biomarkers and phenotypes in predicting and treating mental disorders, and what such definitions, predictions, and interventions portend for concepts and views of sickness, criminality, professional competency, and social functioning. Given these issues, we offer that a preparatory neuroethical framework is required to define and guide the ways in which RDoC-oriented research can—and arguably should—be utilized in clinical psychiatry, and perhaps more broadly, in the social sphere.
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Muzyk AJ, Gagliardi JP, Rakesh G, Jiroutek MR, Radhakrishnan R, Pae CU, Masand PS, Szabo ST. Development of a Diverse Learning Experience for Diverse Psychiatry Resident Needs: A Four-Year Biological Psychiatry Curriculum Incorporating Principles of Neurobiology, Psychopharmacology, and Evidence-Based Practice. Psychiatry Investig 2017; 14:289-297. [PMID: 28539947 PMCID: PMC5440431 DOI: 10.4306/pi.2017.14.3.289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 03/15/2016] [Accepted: 06/03/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.
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Affiliation(s)
- Andrew J Muzyk
- Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jane P Gagliardi
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - Gopalkumar Rakesh
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - Michael R Jiroutek
- Department of Clinical Research, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
| | | | - Chi-Un Pae
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Prakash S Masand
- Academic Medicine Education Institute, Duke-NUS Medical School, Singapore
- Global Medical Education, New York, NY, USA
| | - Steven T Szabo
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
- Mental Health Service Line, Veterans Affairs Medical Center, Durham, NC, USA
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Perez DL, Torous J, Stern AP, Padmanabhan JL, Keshavan MS. Response to "Tandon et al. Psychiatry is a clinical neuroscience, but how do we move the field". Asian J Psychiatr 2016; 22:15-6. [PMID: 27520888 DOI: 10.1016/j.ajp.2016.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/28/2016] [Indexed: 11/17/2022]
Affiliation(s)
- David L Perez
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA.
| | - John Torous
- Harvard Longwood Psychiatry Residency Training Program, Boston, MA, USA; Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adam P Stern
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Berenson Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Jaya L Padmanabhan
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Department of Behavioral Neurology and Neuropsychiatry, Belmont, MA, USA
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Tandon R, Rankupalli B, Suryadevara U, Thornton J. Psychiatry is a clinical neuroscience, but how do we move the field? Asian J Psychiatr 2015; 17:135-7. [PMID: 26419193 DOI: 10.1016/j.ajp.2015.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Rajiv Tandon
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Babu Rankupalli
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Uma Suryadevara
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
| | - Joseph Thornton
- Psychiatry Service, North Florida/South Georgia Veterans Healthcare System, Department of Psychiatry, University of Florida College of Medicine, 1149 Newell Drive, L4-100, Gainesville, FL 32611, USA.
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20
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Keshavan MS, Mehta UM. Is psychiatry in need of a course correction? Asian J Psychiatr 2015; 17:1-2. [PMID: 26541891 DOI: 10.1016/j.ajp.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
| | - Urvakhsh M Mehta
- National Institute of Mental Health and Neurosciences, Bangalore, India
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21
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"The time is now": Integrating neuroscience into psychiatry training. Asian J Psychiatr 2015; 17:126-7. [PMID: 26456208 PMCID: PMC5347978 DOI: 10.1016/j.ajp.2015.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/21/2022]
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22
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Integrating neuroscience into psychiatric residency training. Asian J Psychiatr 2015; 17:133-4. [PMID: 26424200 DOI: 10.1016/j.ajp.2015.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/22/2022]
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23
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Silbersweig DA. Bridging the brain-mind divide in psychiatric education: The neuro-bio-psycho-social formulation. Asian J Psychiatr 2015; 17:122-3. [PMID: 26464238 DOI: 10.1016/j.ajp.2015.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/30/2022]
Abstract
Psychiatrists of the future need to have a strong working knowledge of the organ they work with-the brain. Neuropsychiatry is now more than a paradigm. Systems-level behavioral neuroscience, while still evolving, is mature enough to provide circuit-based foundation. Cellular and molecular neuroscience is starting to yield further mechanistic understanding. It is important to integrate such approaches into an evidence-based, bio-psycho-social formulation, with increasing implications for disease taxonomy, diagnosis and treatment.
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24
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Freudenreich O, Kontos N, Querques J. Remembering psychiatry's core strengths while incorporating neuroscience. Asian J Psychiatr 2015; 17:124-5. [PMID: 26456209 DOI: 10.1016/j.ajp.2015.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Oliver Freudenreich
- Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Nicholas Kontos
- Division of Psychiatry and Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - John Querques
- Division of Psychiatry and Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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25
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Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, United States
| | - Rajiv Tandon
- University of Florida, Gainesville, FL, United States
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