DOLORES KONG
New York Times Syndicate (January 13, 2000) It may not really be necessary for law
enforcement to intervene between the two disciplines, but there is nevertheless
a ``great divide'' that must be closed if research and treatment are to advance
more quickly, says a group of Harvard scientists from both fields.
In an article published Tuesday in the journal
Neurology, researchers say the animosity of the past stems from a difference of
thinking about what causes disease the biology of the brain vs. the psychiatry
of the mind. But the latest science shows biological aspects to psychiatric
disorders, and psychiatric aspects to neurological disorders, according to the
article by neurologists Bruce H. Price and Raymond D. Adams, and psychiatrist
Joseph T. Coyle.
``The two disciplines working together gives
far more hope than continuing these old turf wars,'' said Price, chairman of the
department of neurology at McLean Hospital in Belmont, Mass., in an interview.
Price, the lead author, is also on the staff of Massachusetts General Hospital
and the faculty of Harvard Medical School.
The article, meant to stir controversy and
debate among the nearly 13,000 members of the American Academy of Neurology,
calls for changes in the medical education of both neurologists and
psychiatrists, and for better academic leadership in encouraging collaboration
between the two disciplines.
Massachusetts has one of the highest per
capita concentrations of neurologists in the country, with nearly 10 members of
the neurology academy for every 100,000 people, according to the academy's Web
site, making it particularly noteworthy that the article in Neurology is
authored by Massachusetts scientists, Price said.
Neurology, as a practice, involves the study
and treatment of diseases like stroke, Alzheimer's disease and other
neurological disorders, while psychiatry looks at ailments like depression,
schizophrenia and other mental illnesses.
There has already been cross-fertilization in
the two disciplines, with such recent subspecialties as biological psychiatry
and neuropsychiatry, and with the National Institute of Mental Health and the
National Institute of Neurological Diseases and Stroke making multidisciplinary
grants.
A proposed new Neuroscience Center at the
National Institutes of Health is expected to tie together neuroscience research
being conducted at NIMH, NINDS and seven other institutes.
But specialists in the field said there needs
to be even more such collaboration, and welcomed the article in the journal
Neurology.
``I agree wholeheartedly with everything in
it,'' said Dr. Robin Brey, chairwoman of the American Academy of Neurology's
professional and public information committee. The ``most important point about
this article,'' she said, is its summary of the latest evidence that allows
doctors to ``refine our viewpoints, update our viewpoints and our theories.''
Among the evidence cited in the article for
making the case that the biology of the brain and psychiatry of the mind are
inseparable: Brain imaging scans that allow researchers to see differences in
people with and without mental illness; studies of the amazing plasticity of the
brain, with neurons growing in response to environmental stimuli, like learning;
and brain imaging research showing that people with obsessive-compulsive
disorder who respond to either behavioral therapy or medication both show the
same biologic changes.
``Brain vs. mind. . .it used to be either/or,
nature or nurture. What we're saying is it's really both,'' said Price.
(The Boston Globe web site is at http://www.boston.com/globe/)
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