The overlap between neurology and psychiatry should be obvious, given the two disciplines’ shared concerns with disorders of the human nervous system and the effect of these disorders on such fundamental aspects of our species as thoughts, beliefs, perceptions, and feelings. Nevertheless there is quite a division in terms of training, specialists (medical or otherwise), and service structures for patients who have disorders of the brain or mind. These structural and professional divisions can arguably lead to difficulties for patients accessing appropriate assessments and treatments. In the UK at least it is not currently a requirement of either neurological or psychiatric training to have experience of the other speciality, although progress is being made slowly in this respect with the introduction of more formal neuropsychiatry training modules into both neurology and psychiatry higher training schemes.

This issue of Neurology in Practice may go some way towards addressing this gap. Perusal of the literature will reveal that there have long been those arguing for bridges, rapprochements, and integration between the two disciplines, but real change is harder to see. There continues to be controversy within psychiatry whether the discipline is “mindless” or “brainless” and in which direction it and its practitioners should move.

The persistence of mind brain dualism is sadly all too common in our medical practice. It is not uncommon for patients with primary psychiatric illness to have minimal examination of physical state and the mental state examination is rarely done in a systematic way in general medical or even neurological settings. Of course, sometimes that is entirely appropriate, but just as psychiatrists should hopefully be able to detect and describe physical signs, so too should the neurologist be able to describe adequately and systematically abnormalities of mental state.

Studies have repeatedly shown that psychiatric illness in medical patients …