Sachdev Perminder, Mohan Adith
Centre for Healthy Brain Ageing, School of Psychiatry University of New South Wales Neuropsychiatric Institute Prince of Wales Hospital, Sydney, Australia.
Centre for Healthy Brain Ageing, School of Psychiatry University of New South Wales Neuropsychiatric Institute Prince of Wales Hospital, Sydney, Australia.
Rev Colomb Psiquiatr. 2017 Oct;46 Suppl 1:18-27. doi: 10.1016/j.rcp.2017.05.001. Epub 2017 Jun 16.
With major advances in neuroscience in the last three decades, there is an emphasis on understanding disturbances in thought, behaviour and emotion in terms of their neuroscientific underpinnings. While psychiatry and neurology, both of which deal with brain diseases, have a historical standing as distinct disciplines, there has been an increasing need to have a combined neuropsychiatric approach to deal with many conditions and disorders. Additionally, there is a body of disorders and conditions that warrants the skills sets and knowledge bases of both disciplines. This is the territory covered by the subspecialty of Neuropsychiatry from a 'mental' health perspective and Behavioural Neurology from a 'brain' health perspective. This paper elaborates the neuropsychiatric approach to dealing with brain diseases, but also argues for the delineation of a neuropsychiatric territory. In the process, it describes a curriculum for the training of a neuropsychiatrist or a behavioural neurologist who is competent in providing a unified approach to the diagnosis and management of this set of conditions and disorders. The paper describes in some detail the objectives of training in neuropsychiatry and the key competencies that should be achieved in such higher training after a foundational training in psychiatry and neurology. While aiming for an internationally relevant training program, the paper acknowledges the local and regional differences in training expertise and requirements. It provides a common framework of training for both Neuropsychiatry and Behavioural Neurology, while accepting the differences in skills and emphasis that basic training in psychiatry or neurology will bring to the subspecialty training. The future of Neuropsychiatry (or Behavioural Neurology) as a discipline will be influenced by the successful adoption of such a unified training curriculum.
在过去三十年里,神经科学取得了重大进展,人们开始注重从神经科学基础的角度来理解思维、行为和情感方面的紊乱。虽然精神病学和神经病学都涉及脑部疾病,且在历史上一直是不同的学科,但越来越需要采用综合的神经精神病学方法来应对多种病症和疾病。此外,有一系列病症需要这两个学科的技能和知识基础。从“精神”健康角度来看,这就是神经精神病学亚专业所涵盖的领域;从“大脑”健康角度来看,则是行为神经病学所涵盖的领域。本文阐述了应对脑部疾病的神经精神病学方法,同时也主张划定神经精神病学领域。在此过程中,它描述了针对神经精神病学家或行为神经学家的培训课程,这些专业人员应能够以统一的方法对这一系列病症和疾病进行诊断和管理。本文较为详细地描述了神经精神病学培训的目标以及在完成精神病学和神经病学基础培训后,这种高级培训应达到的关键能力要求。在力求制定一个具有国际相关性的培训计划时,本文承认培训专业知识和要求存在地方和区域差异。它为神经精神病学和行为神经病学提供了一个共同的培训框架,同时也承认精神病学或神经病学基础培训在亚专业培训中所带来的技能和重点方面的差异。神经精神病学(或行为神经病学)作为一门学科的未来将受到这种统一培训课程能否成功采用的影响。