Fener Kalamış Cad. Belvü Apt. No: 75
K: 1 D:2 Kadıköy / İstanbul / Türkiye
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Boundaries of psychiatry have been changing and the field has been exposed to violation and incursion for a long time. Psychiatry has many common interests with other behavioral sciences, mainly Neurology and Psychology. This feature makes psychiatry more powerful and fruitful but also causes some confusion. Like an identity crisis, many questions such as ‘Who am I? What do I look like? What will be my position in the future?’ come to the minds of many psychiatrists. Even physicians sometimes fail to distinguish psychiatrists from psychologists and neurologists. Psychiatry, as a science of mental illnesses, seems more philosophical, sociological and psychological than biological. In public view, common misunderstanding is that psychiatrists are psychologists, who can prescribe some medications to patients. It is assumed that neurologists deal with the brain and the psychiatrists deal with the mind and even the meaning of mind in Turkish language is the same as it is in religion. Psychiatry and neurology have been separated artificially as organic and functional disorders. Those with identifiable brain lesions have been readily identified as having neurologic disorders and others were identified as psychiatric disorders. But it has become clear that the diseases treated by psychiatry, such as bipolar affective disorder and schizophrenia are also brain diseases, with accompanying changes in brain structure and function. These two disciplines also have common interests in diseases such as Parkinson’s (with depression and dementia symptoms), Alzheimer’s disease (with mood symptoms), and other disorders now recognized as having a genetic component like Tourette’s syndrome. Many genetic neurological disorders have some physical, intellectual, emotional difficulties and deficiencies in mental functioning. Great progress has been made in this brain/mind domain in the past decade, most of them by psychiatrists using neuroscience as a source of data. It was also recognized that the best therapeutic responses are seen with combination of medication and psychotherapy. Psychology science has important role on development of psychotherapy. The interests of neurology and psychiatry converge within the framework of neuroscience. Both disciplines should emphasize the importance of basic neuroscience interventions. Psychological theories also have important contribution for more understanding of psychiatric disorders. The education of future psychiatrists and neurologists should be redesigned. Training in psychiatry must include the theoretical constructs, diagnostic terminology, and treatment approaches for these conditions. In neurology, diseases of the spinal cord, peripheral nerves, and the neuromuscular junction and muscle are outside the bounds of neuropsychiatry. Similarly psychiatry has some benefit from psychology science but also psychological theories and psychotherapies are outside the areas of neurology. Neurologists in training should be given a rich clinical exposure to patients suffering from major mental and
neuropsychiatric diseases. Psychiatrists in training should be given more exposure to patients with neurologic syndromes, particularly those that are likely to be accompanied by psychiatric symptoms. As a conclusion, current boundaries in psychiatry are artificial and impractical. Division as organic and functional is invalid and it has resulted in the lack of adequate knowledge in neuroscience. If this kind of separation continues to exist, it will lead to an unavoidable death of psychiatry. Psychiatry should be based on neuroscience instead of psychology.


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