Drs. Yudofsky and Hales Reply

To the Editor: We appreciate the thoughtful responses by our colleagues, Drs. Chaitin and Sachdev, to our editorial. We believe that the “new neuropsychiatry,” with the enlarged purview that “preserve[s] the uniqueness of psychiatry and the unfolding of neuroscience,” welcomed by Dr. Chaitin has already emerged and has been gaining momentum over the past decade. In our opinion, the new neuropsychiatry currently is best manifested by the members and scientific programs of the vibrant and growing American Neuropsychiatric Association. Increasingly, the younger members of the American Neuropsychiatric Association are psychiatrists and neurologists who have had 2 years of subspecialty training in neuropsychiatry or behavioral neurology after completing their respective residencies. The clinical and research foci of most members of the American Neuropsychiatric Association coincide closely with the middle path of clinical neuropsychiatry advocated by Dr. Sachdev.

Although we are both active members and supporters of the American Neuropsychiatric Association, we do not believe that subspecialties of the disciplines of psychiatry and neurology best solve the pervasive problems of the two specialties that we raised in our editorial. Among the most serious of these deficiencies are 1) the continuing stigmatization of people conceptualized to have psychiatric disorders, 2) the failure of many psychiatrists to understand, diagnose, and treat the neurobiological aspects of patients with behavioral and emotional disorders, 3) the failure of many neurologists to understand and treat the psychosocial aspects of patients with sensory-motor disorders, and 4) the arbitrary and confusing cleavage of brain-based disorders into two disparate specialties.