Editorials

The wall between neurology and psychiatry

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7352.1468 (Published 22 June 2002) Cite this as: BMJ 2002;324:1468

Advances in neuroscience indicate it's time to tear it down

  1. Mary G Baker, president, European Parkinson's Disease Association,
  2. Rajendra Kale, assistant editor,
  3. Matthew Menken (MMenken712@aol.com), chairman, research group on medical education, World Federation of Neurology
  1. Kailua, Maybourne Rise, Mayford, Woking, Surrey GU22 0SH
  2. BMJ London WC1H 9JR
  3. 75 Veronica Avenue, Somerset, NJ 08873, USA

    For more than 2000 years in the West, neurology and psychiatry were thought to be part of a single, unified branch of medicine, which was often designated neuropsychiatry. Charcot, Freud, Jackson, Bleuler, among many others, thought in terms of a unified study of the brain and the mind, irrespective of special clinical and research interests. During the 20th century, however, a schism emerged as each of these fields went its separate way. Neurologists focused on those brain disorders with cognitive and behavioural abnormalities that also presented with somatic signs—stroke, multiple sclerosis, Parkinson's, and so forth—while psychiatrists focused on those disorders of mood and thought associated with no, or minor, physical signs found in the neurological examination of the motor and sensory systems—schizophrenia, depression, anxiety disorders, and so on. For certain disorders, conflicting theories emerged about their aetiology and pathogenesis, at times engendering negative …

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