Lecture 13: Neuropsychiatry: Koliatsis

Question 1

What is neuropsychiatry?

Answer 1

Field of medicine in which neurology is necessary in understanding and managing mental and behavioral illness

Question 2

Which 3 specialities are combined in the field of neuropsychiatry?

Answer 2

Psychiatry - neurology - neuropsychology

Question 3

How did treatment options for Parkinson emerge? (3 steps)

Answer 3

1. Discovery modulating neurotransmission of dopamine
2. Use of dopamine modulation in psychotic patients created Parkinson symptoms
3. Parkinson disease treatment got inspired, leading to effective medication

Question 4

What are the 5 neuropsychiatric patients types? What are the 3 most common types?

Answer 4

1. Behavioral neurology model
2. Neurology as a meme
3. Interactive model
4. Neuropsychiatry of pain and autonomic nervous system
5. Neuropsychiatry of psychotropic drug use

Most common = 1,2,3

Question 5

What is the behavioral neurology model?

Answer 5

Neuropathology is both a necessary and sufficient cause of neuropsychiatric disease and the knowledge of it is key to understand and manage psychopathology

Question 6

What do we mean with neuropsychology as a meme?

Answer 6

Neuropathology is probably not necessary and certainly not sufficient for all symptom formation, e.g. conversion disorder

Question 7

What is the interactive model in neuropsychiatry?

Answer 7

Neuropathology is necessary, but not a sufficient cause of symptoms and not sufficient to understand/manage psychopathology

Question 8

What is the neuropsychiatry of pain and the autonomic nervous system?

Answer 8

Neuropathology originates within the peripheral and autonomic nervous system and is related to somatoform and visceral symptoms

Question 9

What is the neuropsychiatry of psychotropic drug use?

Answer 9

Psychopathology and side effects are mediated via psychotropic drugs, requiring careful differential diagnosis and management to distinguish between medication effects and disease symptoms

Question 10

Why does modern neurology, psychiatry and neuropsychiatry experience a renaissance? (2)

Answer 10

1. There are many new technologies and methods to study the human brain
2. There is an increasing prevalence of certain disorders, especially neurodegenerative and vascular brain disease

Question 11

Which patient type especially benefits neuropsychiatric expertise? (2)

Answer 11

1. Those in whom neuropathology is key driver of psychopathology
2. Those in whom neuropathology is a modifier in the illness

Question 12

What are 4 pioneering neuropsychiatrists?

Answer 12

1. Nissl: understanding psychosis, studying with new technique that was revolutionary in neuroanatomy
2. Forel: identified tracts now useful for DBS
3. Alzheimer: described plaques in brain of patient with memory loss, hallucinations and confusion
4. Freud: psychoanalysis, aware of limitations of neuropathology

Question 13

What are some limitations of neuropsychiatry? (2)

Answer 13

1. Assignment of cause is problematic
2. Change in the brain can change behavior, but changes in behavior can change the brain too.