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神经精神病学与神经立体主义。

Neuropsychiatry and neural cubism.

作者信息

Benjamin Sheldon

机构信息

S. Benjamin is professor of psychiatry and neurology and vice chair for education in psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts.

出版信息

Acad Med. 2015 May;90(5):556-8. doi: 10.1097/ACM.0000000000000531.

Abstract

The art movement known as Cubism did not represent a failure of perspective but, rather, was a movement aimed at advancing art by juxtaposing different perspectives. In this issue, Taylor and colleagues describe the current approach by neurologists and psychiatrists to patients with brain disorders as "Neural Cubism" because of the competing angles of these specialists' perspectives about these disorders. They advocate both integrated training for all residents in the two fields and a system of "nested hierarchies" to reclassify brain disorders according to their effect on levels of brain function. The unspoken premise of their article is that it is time for psychiatry and neurology to reunite.This Commentary takes the view that reuniting the long-separated specialties of neurology and psychiatry would not necessarily create better care for all patients with brain disorders but that trainees in both fields would benefit from increased training in the complementary specialty. The new Accreditation Council for Graduate Medical Education clinical neuroscience milestones for psychiatry training and psychiatry milestones for neurology training are steps in the right direction. Increasing opportunities for combined neurology-psychiatry training will help create a cadre of specialists equipped to efficiently care for complex patients within emerging accountable care organizations. Drawing from two fields in the service of understanding brain-behavior interactions increases the potential for innovation at their interface. The author concludes that the time has come to increase the neurological and neuroscience content of psychiatry training but not to unite the two fields.

摘要

被称为立体主义的艺术运动并非透视法的失败,相反,它是一场旨在通过并列不同视角来推动艺术发展的运动。在本期杂志中,泰勒及其同事将神经科医生和精神科医生目前对脑部疾病患者的治疗方法描述为“神经立体主义”,因为这些专家对这些疾病的看法存在相互竞争的角度。他们主张对这两个领域的所有住院医师进行综合培训,并建立一个“嵌套层级”系统,根据脑部疾病对脑功能水平的影响对其进行重新分类。他们文章中未言明的前提是,精神病学和神经学该重新联合了。本评论认为,将长期分离的神经学和精神病学专业重新联合起来不一定能为所有脑部疾病患者提供更好的治疗,但这两个领域的受训人员将从增加互补专业的培训中受益。新的研究生医学教育认证委员会针对精神病学培训的临床神经科学里程碑以及针对神经学培训的精神病学里程碑是朝着正确方向迈出的步伐。增加神经学 - 精神病学联合培训的机会将有助于培养一批有能力在新兴的责任医疗组织中高效护理复杂患者的专家。借鉴这两个领域来理解脑 - 行为相互作用增加了它们交叉领域创新的潜力。作者得出结论,现在是增加精神病学培训中神经学和神经科学内容的时候了,但不是将这两个领域合并。

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