建立大脑心智障碍的统一分类系统:将整合临床神经科学的呼吁付诸行动。

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES Cognitive and Behavioral Neurology Pub Date : 2023-12-01 DOI:10.1097/WNN.0000000000000353
Michael P H Stanley, David A Silbersweig, David L Perez
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引用次数: 0

摘要

将大脑划分为神经病学和精神病学的专业领域产生了许多细微的优势,但这些筒仓阻碍了全面理解和情境化精神生活及其疾病的基本原理。如果不将学术和临床实践中同一机构的两个专业的界限相互交叉,对这些基本原理的科学探究就无法充分发挥其潜力。我们建议,为了真正将大脑和精神疾病整合到研究和临床护理中,我们必须仔细重新审查其疾病的分类(疾病学),将其作为一种工具,以开发一个连贯的病理和心理框架。我们呼吁来自神经病学、精神病学、行为神经病学、神经精神病学、神经心理学和其他相关子专业(如老年精神病学)的专业组织召集一个多学科工作组,以确定其子专业的当前分类原则,并致力于开发一种综合的疾病学。我们承认,共享分类系统在哲学和政治上都是一个困难的命题,其影响将在教育、临床、科学、计划和社会文化领域具有变革潜力。如果这一举措得以实现,将为减少各种复杂大脑疾病的耻辱感(并促进报销平等)(无论传统的神经与精神概念如何)迈出决定性的一步。
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Toward a Unified Classification System for Brain-Mind Disorders: Putting Calls for Integrated Clinical Neuroscience Into Action.

Dividing the brain-mind into the specialized fields of neurology and psychiatry has produced many granular advantages, but these silos have imposed barriers to comprehensively understanding and contextualizing the fundamentals governing mental life and its maladies. Scientific inquiry into these fundamentals cannot reach its full potential without interdigitating the boundaries of two specialties of the same organ for both scholarship and clinical practice. We propose that to truly integrate disorders of the brain and the mind for research and clinical care, we must carefully reexamine the classification of its disorders (nosology) as an instrument to develop a coherent pathological and psychological framework. We call on professional organizations from neurology, psychiatry, behavioral neurology, neuropsychiatry, neuropsychology, and other relevant subspecialties (eg, geriatric psychiatry) to convene a multidisciplinary task force to define the current classification principles of their subspecialties and work toward developing an integrated nosology. The effect of a shared classification system, which we acknowledge is a difficult proposition philosophically and politically, would have transformative potential across educational, clinical, scientific, programmatic, and sociocultural realms. If accomplished, this initiative would provide a definitive step toward reducing stigma (and promoting reimbursement parity) for the full spectrum of complex brain disorders (regardless of traditional neurologic vs psychiatric conceptualizations).

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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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