Neuropsychiatry, also known as behavioral neurology, refers to a relatively new branch of medicine that involves both neurology and psychiatry and treatment of pathologies that involve the two disciplines — neuropsychiatric disorders. Practitioners have completed medical school and either neurology residencies or psychiatric residencies, or both, and have advanced training and education in neurology, psychiatry and pharmacology. Neuropsychologists are not physicians but psychologists with a PhD, and work with neuropsychiatrists to conduct testing, evaluation and monitoring of patient progress. The origins of neuropsychiatric disorders can stem from a physical injury, an unknown development, a psychological disorder or a side effect from a medication prescribed to treat either a physical or psychiatric disorder. Common neuropsychiatric disorders include seizures, cognitive deficits, uncontrolled anger, attention deficits, migraine headaches and different types of palsy, among other pathologies.
Migraine headaches and even uncomplicated headaches are common neuropsychiatric disorders. Headaches may range from annoying to disabling. They may be of unknown etiology, caused by a physical injury, a reaction to stress or anxiety or secondary to medications used to treat a physical or psychiatric disease. A neuropsychiatrist will attempt to identify the precipitating cause of either type of headache, eliminate it as necessary, change medications as necessary or begin a medication to treat the condition based on the suspected cause.
Another common neuropsychiatric disorder is that of attention deficit hyperactivity disorder (ADHD). The cause of this frequently occurring disorder in children is unknown and the diagnostic criteria are sometimes disputed, but its constellation of symptoms is well recognized. These disorders affect a child's ability to concentrate, maintain attention without succumbing to distraction and transfer new information into long-term memory. ADHD is often treated with a stimulant-form of medication used in adult narcoleptics. The physiology of why these stimulant drugs act to calm these children is unknown.
Depression and its constellation of physical symptoms is another example of neuropsychiatric disorders with symptoms that are physical, psychological and cognitive. Some medications used to treat depression and other psychiatric disorders have side effects involving uncontrolled movement known as tardive dyskinesia, as well as insomnia. Again, these physical side effects of a drug used to control a primarily psychological disorder are a classic example of neuropsychiatric disorders.
One other type of neuropsychiatric disorder can be illustrated by a recovering traumatic closed head injury (CHI) patient. Advancements in emergency care, neurosurgery and critical care have allowed patients to survive what were once fatal automotive accidents. Many survivors, however, deal with the neuropsychiatric disorders that are part of a closed head injury including seizures, personality changes and other symptoms. Cognition may be affected, insofar as literacy and even counting skills could be impaired. These patients may demonstrate an inability to control impulses, whether they are ones of aggression or irresponsibility.
