Neuropsychiatry Focuses on Bringing Two Fields Together

It’s not uncommon for people who have neurological disorders to experience behavioral and emotional symptoms. The field of neuropsychiatry is dedicated to addressing this issue and bringing a neurobiological understanding to the field of psychiatry.

“We focus on the intersection between neurology and psychiatry and on understanding the full range of cognitive, emotional and behavioral manifestations that can present with different neurological disorders,” said Gaston C. Baslet, MD, chief of the Neuropsychiatry Division in the Brigham and Women’s Hospital Department of Psychiatry and co-director of the Center for Brain/Mind Medicine. “There’s a lot of overlap, and it’s important for these two specialties to work together to understand the emotional disorders that can arise from alterations in the function of the brain.”

At the Intersection of Psychiatry and Neurology

Psychiatric conditions are common in people with neurological diseases, including Alzheimer’s disease and other forms of dementia, multiple sclerosis and epilepsy. They also can occur in people with brain tumors and those who have experienced traumatic brain injuries, strokes or infectious diseases of the nervous system, among other conditions. “We want to understand how a brain affected by neurological illness can also have all sorts of impact on emotional and cognitive function,” Dr. Baslet said.

“The Brigham has a large group of professionals interested in brain and behavior. This puts us in a unique position to better understand and offer help to address these disorders,” he added. “We have a number of experts in neuropsychiatry in our group. Additionally, as part of the Center for Brain/Mind Medicine, we work closely and collaborate with the behavioral neurology group and the neuropsychology group.”

As a tertiary care center, the Brigham sees people with both common and rare neurologic and psychiatric disorders. Because of the large volume of inpatients who are in more acute stages of neurological disease—which frequently has a psychiatric component—inpatient consultations are also a growing area of specialization.

Clinical research is an important element of the work done by the Brigham’s neuropsychiatrists. “We are really expanding our research as a way to grow our division,” Dr. Baslet said. “We are developing clinical trials that are at the cutting edge of research to try to better treat functional neurological disorders.” He is particularly excited about one trial that is looking at the role of inflammation in severe depression and targeting that inflammation as a treatment strategy.

The Future of Neuropsychiatry

Training the next generation of leaders in the field is another key component of the Brigham’s neuropsychiatry program. The Fellowship in Behavioral Neurology/Neuropsychiatry is available to those who have completed residencies in either neurology or psychiatry. It allows trainees to gain experience in both behavioral neurology, which focuses on cognitive impairment, and neuropsychiatry, which focuses on psychiatric and emotional disorders arising from neurological disease. Fellows spend two years learning to diagnose and treat a broad range of neuropsychiatric disorders. They also have the opportunity to pursue various areas of research.

Through Harvard Medical School, the Brigham is also involved in continuing medical education classes for those who are already practicing medicine and want a greater understanding of the depth and breadth of neuropsychiatry.