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The Neuroscience Perspective and the Changing Role of the Psychiatrist

The Challenge for Psychiatric Educators

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Abstract

The practice of psychiatry is undergoing rapid and radical changes because of health care reorganization and the advances in basic science. Therefore, psychiatric educators must confront the redefinition of the role of the psychiatrist in the health care system. The model of the psychiatrist who primarily provides office-based psychotherapy is outmoded. Rather, the psychiatrist must become a clinical expert in brain and behavioral sciences, with mastery over an expanding array of diagnostic techniques and responsibility for directing integrated multidisciplinary treatment and rehabilitative services. To ensure this expertise, students must receive a firm grounding in neuroscience, molecular genetics, and brain imaging in addition to the traditional curriculum.

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References

  1. Dorwart RA: Managed mental health care: myths and realities in the 1990s. Hospital and Community Psychiatry 1990; 41:1087–1091

    CAS  PubMed  Google Scholar 

  2. Mirin SM: The changing face of mental health care: doing what’s needed, doing what’s right. Psychiatric Times 1993; 10:29–31

    Google Scholar 

  3. Kiesler CA, Sibulkin AE: Mental Hospitalization: Myths and Facts About a National Crisis. Newbury Park, CA, Sage Publications, 1987

    Google Scholar 

  4. Association of American Medical Colleges: National Resident Matching Program, NRMP Data, 1994. Washington, DC, Association of American Medical Colleges, 1994

    Google Scholar 

  5. Association of American Medical Colleges: American Medical Education, Institutions, Programs and Issues. Washington, DC, Association of American Medical Colleges, 1992

    Google Scholar 

  6. Olfson M, Pincus HA, Dial TH: Professional practice patterns of U.S. psychiatrists. Am J Psychiatry 1994; 151:89–95

    CAS  PubMed  Google Scholar 

  7. Dorwart RA, Chartock LR, Dial T, et al: A national study of psychiatrists’ professional activities. Am J Psychiatry 1991; 149:1499–1505

    Google Scholar 

  8. Gabbard GO: The transition from residency to managed care nightmare. Academic Psychiatry 1992; 16:119–126

    Article  Google Scholar 

  9. Hyman SE, Nestler EJ: The Molecular Foundations of Psychiatry. Washington, DC, American Psychiatric Press, 1993

    Google Scholar 

  10. Gusella JF, Wexler NS, Conneally PM, et al: A polymorphic DNA marker genetically linked to Huntington’s disease. Nature 1983; 306:234–238

    Article  CAS  PubMed  Google Scholar 

  11. Huntington’s Disease Collaborative Research Group: a novel gene containing a trinucleotide repeat that is expanded and unstable on Huntington’s disease chromosomes. Cell 1993; 72:971–983

    Article  Google Scholar 

  12. Institute of Medicine: Mapping the Brain and Its Functions. Washington, DC, National Academy Press, 1993

    Google Scholar 

  13. Baxter LR Jr, Schwartz JM, Bergman KS, et al: Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Arch Gen Psychiatry 1992; 49:681–689

    Article  CAS  PubMed  Google Scholar 

  14. Cohen D, Chumokov I, Weissembach J: A first generation physical map of the human genome. Nature 1993; 366:698–701

    Article  CAS  PubMed  Google Scholar 

  15. Gershon ES, Cloninger CR: Genetic Approaches to Mental Disorders. Washington, DC, American Psychiatric Press, 1994

    Google Scholar 

  16. Corder EH, Saunders AM, Strittmatter WJ, et al: Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late-onset families. Science 1993; 261:921–923

    Article  CAS  PubMed  Google Scholar 

  17. Coyle JT, Price DL, DeLong MR: Alzheimer’s disease: a disorder of cortical cholinergic innervation. Science 1983; 219:1184–1190

    Article  CAS  PubMed  Google Scholar 

  18. Kosick KS: Alzheimer’s disease: a cell biological perspective. Science 1992; 256:780–783

    Article  Google Scholar 

  19. Coyle JT, Oster-Granite ML, Reeves R, et al: Down syndrome and the trisomy 16 mouse: impact of gene imbalance on brain development and aging, in Genes, Brain and Behavior, edited by McHugh PR, McKusick V. New York, Raven, 1991, pp 85–99

  20. Robinson MB, Coyle JT: Glutamate and related acidic excitatory neurotransmitters: from basic science to clinical application. FASEB J 1987; 1:446–455

    CAS  PubMed  Google Scholar 

  21. Hyman S, Coyle JT: The neuroscientific foundations of psychiatry, in American Psychiatric Press Textbook of Psychiatry, 2nd Edition, edited by Hales RE, Yudofsky SC, Talbott JA. Washington, DC, American Psychiatric Press, 1994, pp 1–33

  22. Seeman P, Guan HC, Van Tol HHM: Dopamine D-4 receptors elevated in schizophrenia. Science 1993; 365:441–45

    CAS  Google Scholar 

  23. Shenton ME, Kikinis R, Jolesz FA, et al: Abnormalities of the left temporal lobe and thought disorder in schizophrenia: a quantitative magnetic resonance imaging study. N Engl J Med 1992; 327:604–612

    Article  CAS  PubMed  Google Scholar 

  24. Shiino A, Matsuda M, Morikawa S, et al: Proton magnetic resonance spectroscopy with dementia. Surg Neurol 1993; 39:143–147

    Article  CAS  PubMed  Google Scholar 

  25. Wong DF, Wagner HN Jr, Tune LE, et al: Positron emission tomography reveals elevated D-2 dopamine receptors in drug-naive schizophrenics. Science 1986; 234:1558–1563

    Article  CAS  PubMed  Google Scholar 

  26. Berman KF, Torrey EF, Danial JG, et al: Regional cerebral blood flow in monozygotic twins discordant and concordant for schizophrenia. Arch Gen Psychiatry 1992; 49:996–1001

    Article  Google Scholar 

  27. Rauch SL, Jenike MA, Alpert NM, et al: Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen-15 carbon dioxide and positron emission tomography. Arch Gen Psychiatry 1994; 51:62–70

    Article  CAS  PubMed  Google Scholar 

  28. Rauch SL, Renshaw PF: Clinical neuroimaging in psychiatry. Harvard Review of Psychiatry 1995; 2:297–312

    Article  CAS  PubMed  Google Scholar 

  29. Falloon IRH, Boyd JL, McGill CW: Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal study. Arch Gen Psychiatry 1985; 42:887–896

    Article  CAS  PubMed  Google Scholar 

  30. Weissman MM, Markowitz JC: Interpersonal psychotherapy: current status. Arch Gen Psychiatry 1994; 51:599–606

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, MA, 02178, USA

    Joseph T. Coyle M.D. (Eben S. Draben Professor of Psychiatry and of Neuroscience, and chairman of the Consolidated)

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  1. Joseph T. Coyle M.D.
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Coyle, J.T. The Neuroscience Perspective and the Changing Role of the Psychiatrist. Acad Psychiatry 19, 202–212 (1995). https://doi.org/10.1007/BF03341546

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