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废除精神病学,废除神经病学:迈向统一的脑医学学科。

Abolish Psychiatry, Abolish Neurology: Toward a Unified Discipline of Brain Medicine.

作者信息

Lakhan Shaheen E

机构信息

Medical Office, Click Therapeutics, Inc., New York, USA.

Department of Neurology, Western University of Health Sciences, Pomona, USA.

出版信息

Cureus. 2025 May 26;17(5):e84817. doi: 10.7759/cureus.84817. eCollection 2025 May.

Abstract

The longstanding division between psychiatry and neurology is a historical artifact, not a scientific necessity. Despite addressing the same organ, these fields operate as separate disciplines, fragmenting education, care, research, regulation, and reimbursement. This editorial argues for the abolition of that divide and the creation of a unified discipline of brain medicine. Drawing on advances in systems neuroscience, artificial intelligence, and neuromodulation, I present a comprehensive critique of the dual-specialty model and propose an integrated alternative. The editorial synthesizes data from brain network research, the lived inefficiencies of medical training and healthcare delivery, and the constraints placed on innovation by legacy frameworks. I highlight how computational psychiatry, neurobiology, and regulatory reform can converge to enable a model that is mechanistically grounded and clinically effective. Through two conceptual tables, I demonstrate the shared circuitry across traditionally labeled psychiatric and neurological conditions, and the system-wide efficiencies gained through integration. The future of brain care lies not in silos, but in circuits, and it is time our institutions, educators, payers, and innovators catch up with science. This is a call to unify how we understand, teach, regulate, and treat the brain not only for administrative elegance but also for clinical reality, therapeutic progress, and human dignity.

摘要

精神病学与神经病学之间长期存在的划分是历史遗留产物,并非科学上的必然。尽管二者都涉及同一器官,但这两个领域却作为独立学科运作,致使教育、护理、研究、监管及报销等方面碎片化。本社论主张消除这种划分,创建一门统一的脑医学学科。借鉴系统神经科学、人工智能及神经调节等领域的进展,我对双专业模式进行了全面批判,并提出了一种综合替代方案。本社论综合了脑网络研究数据、医学培训与医疗服务中实际存在的低效问题,以及传统框架对创新的限制。我强调了计算精神病学、神经生物学及监管改革如何能够汇聚起来,以促成一种基于机制且临床有效的模式。通过两个概念表,我展示了传统上归类为精神疾病和神经疾病的病症之间共享的神经回路,以及整合后在全系统范围内获得的效率提升。脑保健的未来不在于各自为政,而在于神经回路,现在是我们的机构、教育工作者、支付方和创新者跟上科学步伐的时候了。这是一个呼吁,要统一我们理解、教授、监管和治疗大脑的方式,不仅是为了行政上的简洁,更是为了临床实际、治疗进展和人类尊严。

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Time for Brain Medicine.脑医学时间。
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Functional neurological disorder: new subtypes and shared mechanisms.功能性神经障碍:新亚型和共同机制。
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