In recent years, there have been calls within the medical profession to erase the distinctions between neurological and psychiatric disorders. As scientists, most medical professionals do realize that before a step like this can be put into place, there needs to be conclusive evidence that both types of disorders are similar enough to categorize in the same way. Is there evidence?
Before any conclusion can be formulated, it’s important to determine what is the difference between these two types of disorders.
The following information should help do that.
What Are Neurological Disorders
Neurological disorders occur because of malfunctions or damage to the nervous system. That would include the brain, spinal cord, and nerves.
The list of most notable neurological disorders would include epilepsy, multiple sclerosis, Huntington’s disease, Parkinson’s disease, and Alzheimer’s disease.
Treatment for these types of disorders falls under the purview of a neurologist. Typically, an MRI or brain scam would be used to detect and diagnose the existence of one of these conditions in the brain. If a patient gets such a diagnosis, the treatment options would include surgical procedures, physical therapy, mental therapy, and medication.
What Are Psychiatric Disorders
Psychiatric disorders are typically associated with disturbed behavior and a patient’s emotional state. Treatment for these types of disorders falls under the purview of a psychiatrist, psychologist, or licensed therapist.
These types of disorders occur for a variety of reasons. The list of potential causes of psychiatric disorders includes:
- Trauma (childhood abuse, death of family member, witnessing accidents, natural disasters)
- Genetics (some people have a family history of mental illnesses)
- Substance Abuse (drugs or alcohol)
- Medical conditions like infections
- Prenatal damage
- Brain defects or injury
Common psychiatric disorders include Neurodevelopmental Disorders (ADHD, Autism), Bipolar and Related Disorders (mania, depression), Anxiety Disorders (social anxiety, generalized anxiety, panic, separation anxiety, and phobias), Stress-Related Disorders (PTSD), Dissociative Disorders (amnesia), eating disorders (Anorexia, Bulimia), and addiction.
Treatment for these conditions includes therapy, medication, or a combination of the two.
The Common Thread?
After looking at the difference between these two types of disorders, it becomes clear there is somewhat of a common thread. What researchers have found is that some psychiatric disorders might occur after being initiated by a neurological disorder.
This is backed by a study published in 2015, led by Nicolas Crossley of the Kings College in London, looking at the “Neuroimaging distinction between neurological and psychiatric disorders(1)“, found that:
The two classes of disorders affected distinct functional networks. Similarity within classes was higher than between classes; furthermore, similarity within class was higher for neurological than psychiatric disorders.
According to Desiree Shapiro(2), HS Associate Clinical Professor, Psychiatry at University of California, San Diego, this potential link creates a diagnostic problem.
Here is what she said in a quote about how a physician might have to proceed when trying to make a proper diagnosis:
“In the absence of these findings, a primary care provider might be faced with a difficult decision point when considering a referral to a psychiatrist versus neurologist,” Shapiro then added. “Common and vague symptoms such as fatigue, mood alterations, or memory changes will require additional history-taking and physical examination in order to elucidate the most appropriate referral.”
Here is what researchers know. Both types of disorders show up as abnormalities in the brain’s anatomy. At issue is whether or not both types of disorders evolve from the same areas of the brain.
The study mentioned earlier led by Nicolas Crossley might provide enough evidence to support that both types of disorders are different and distinct. Over 168 published brain imaging (MRI) studies, the study found divergent neuroimaging findings in both disorders. That led the researchers to believe that from a neuroimaging perspective, the differences are evident.
Like many studies in this area, there is still some ambiguity associated with the results. In this study, they were unable to control for psychiatric patients who were taking psychotropic drugs. That made it difficult to discern brain structural abnormalities caused by psychosis versus abnormalities caused by long term drug use.
Given potential issues with determining the proper diagnosis, it’s easy to see why a primary care physician would have difficulty determining the right treatment path for patients. For now, it would seem that the difference between these two types of disorders is enough to prompt neurology and psychiatric professionals to work together to find the right treatment for patients.
- Crossley NA, Scott J, Ellison-Wright I, Mechelli A. Neuroimaging distinction between neurological and psychiatric disorders. Br J Psychiatry. 2015 Nov;207(5):429-34. doi: 10.1192/bjp.bp.114.154393. Epub 2015 Jun 4. PMID: 26045351; PMCID: PMC4629073.
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