Dr. W.C. Darby is an Assistant Professor of Psychiatry, Department of Psychiatry and Biobehavioral Sciences, Division of Forensic Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA. Dr. Considine is an Associate Professor of Neurology, and Dr. R.R. Darby is an Assistant Professor of Neurology, Department of Neurology, Division of Behavioral Neurology, Vanderbilt University Medical Center, Nashville, TN.
J Am Acad Psychiatry Law. 2024 Jun 4;52(2):139-148. doi: 10.29158/JAAPL.240018-24.
Forensic psychiatrists may be asked to opine on neurological evidence or neurological diseases outside the scope of their expertise. This article discusses the value of involving experts trained in behavioral neurology in such cases. First, we describe the field of behavioral neurology and neuropsychiatry, the subspecialty available to both neurologists and psychiatrists focused on the behavioral, cognitive, and neuropsychiatric manifestations of neurological diseases. Next, we discuss the added value of behavioral neurologists in forensic cases, including assisting in the diagnostic evaluation for complex neuropsychiatric diseases, using expertise in localization to provide a strong scientific basis for linking neurodiagnostic testing to relevant neuropsychiatric symptoms, and assisting in relating these symptoms to the relevant legal question in cases where such symptoms may be less familiar to forensic psychiatrists, such as frontal lobe syndromes. We discuss approaches to integrating behavioral neurology with forensic psychiatry, highlighting the need for collaboration and mentorship between disciplines. Finally, we discuss several forensic cases highlighting the additional value of experts trained in behavioral neurology. We conclude that forensic psychiatrists should involve behavioral neurology experts when encountering neurological evidence that falls outside their scope of expertise, and the need for further cross-disciplinary collaboration and training.
法医精神病学家可能会被要求对超出其专业知识范围的神经学证据或神经疾病发表意见。本文讨论了在这种情况下,让接受过行为神经学专业培训的专家参与的价值。首先,我们描述了行为神经学和神经精神病学领域,这是神经科医生和精神科医生的一个亚专科,专注于神经疾病的行为、认知和神经精神表现。其次,我们讨论了行为神经学家在法医案例中的附加价值,包括协助复杂神经精神疾病的诊断评估,利用定位专业知识为将神经诊断测试与相关神经精神症状联系起来提供强有力的科学基础,以及在法医精神病学家不太熟悉的情况下,如额叶综合征,协助将这些症状与相关的法律问题联系起来。我们讨论了将行为神经学与法医精神病学相结合的方法,强调了学科之间合作和指导的必要性。最后,我们讨论了几个突出表现出经过行为神经学培训的专家的附加价值的法医案例。我们的结论是,法医精神病学家在遇到超出其专业知识范围的神经学证据时,应寻求行为神经学专家的意见,需要进一步跨学科合作和培训。