ABSTRACT
This chapter discusses the overlap between neurology and psychiatry and considers psychiatric diagnosis and management, particularly where it is relevant to neurology. Biological psychiatry and behavioural neurology are bridging the gap between neurology and psychiatry. Transcranial magnetic stimulation (TMS) is one of several new therapeutic techniques involving direct stimulation of the central nervous system. TMS over the frontal lobes appears to have an antidepressant effect, and may even be an alternative to electroconvulsive therapy. Disturbance of conscious level or orientation indicates organic brain disease until proved otherwise. It is for this reason that the neurologist’s mental state concentrates on whether or not the patient is ‘alert and orientated’. Psychiatric diagnoses show good inter-rater reliability and predict outcome and treatment responsiveness. It is useful to think of a hierarchy of diagnosis with all psychiatric diagnoses being trumped by organic mental disorders. Functional neuroimaging has provided objective evidence of abnormalities of brain function to match the subjective descriptions of symptoms.
