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Editorial   |    
What's New in Neuropsychiatry
Stuart C. Yudofsky, M.D.; Robert E. Hales, M.D., M.B.A.
The Journal of Neuropsychiatry and Clinical Neurosciences 1999;11:1-4.

This issue of The Journal of Neuropsychiatry and Clinical Neurosciences heralds the beginning of our second decade of publication. In addition to changing the "look" of the cover, we are marking the anniversary by adding new features—both to the content of the Journal and how the reader may gain access to articles and features.

Before we turn to the future, however, the occasion provides an opportunity to express our appreciation to the many who have enabled the Journal to flourish over its first ten years. To those who have been so intimately connected with this publication—our Editors; the officers and involved members of the American Neuropsychiatric Association; our hard-working and creative staff at the Journals Division of American Psychiatric Press; our Board of Directors; the hundreds of gifted authors who have submitted manuscripts; and the many more devoted professionals who have provided independent reviews of these submissions—we express our gratitude. As a result of your efforts, this time has passed pleasurably for us, and fleetingly. In particular, we thank you, our loyal reader, for providing meaning and direction to the efforts of those who have been involved with the creation, publication, and sustenance of your Journal.

In our initial editorial ten years ago we endeavored to define neuropsychiatry, to explain why we believed the field of neuropsychiatry was on the brink of a reemergence, and to set the goals for this new publication.1 In that editorial, we emphasized the timelessness and power of the neuropsychiatric paradigm, a concept that is based on a solid foundation of integration. We wrote:

Although there is considerable disagreement about just what neuropsychiatry comprises, fundamental to any definition is the indelible inseparability of brain and thought, of mind and body, and of mental and physical. Neuropsychiatry spans these interrelationships to enlarge our understanding of cognitive, emotional, and behavioral function and dysfunction.

In the very next issue of the Journal, psychiatrist and neuroscientist Eric Kandel, in a paper that is now a classic, "Genes, Nerve Cells, and the Remembrance of Things Past,"2 expanded on the conceptual interface of mind and body in the context of the great promise of neurobiology:

In the last few years, biology has undergone a remarkable increase in explanatory power and range that is now having a broad impact on medicine. This new biology also promises to revolutionize our understanding of mental processes. As a result, when intellectual historians look back upon the second half of the 20th century, they are likely to acknowledge that the most interesting insights into our understanding of the mind will not have come from the traditional disciplines concerned with the mind; they will not come from philosophy or from the arts, nor from psychoanalysis or even from cognitive psychology, but from biology, and specifically from molecular biology and from neurobiology.

This past year, Dr. Kandel advanced this theme in an essay entitled "A New Intellectual Framework for Psychiatry."3 In this paper, he stated:

We now need to ask, "How do the biological processes of the brain give rise to mental events, and how in turn do social factors modulate the biological structure of the brain?" In the attempt to understand a particular mental illness, it is more appropriate to ask, "To what degree is this biological process determined by genetic and developmental factors? To what degree is it environmentally or socially determined? To what degree is it determined by a toxic or infectious agent?" Even the mental disturbances that are considered to be the most heavily determined by social factors must have a biological component, since it is the activity of the brain that is being modified.

We believe that these are classic questions asked by neuropsychiatrists and that the authors of papers in The Journal of Neuropsychiatry and Clinical Neurosciences, over its first decade of existence, have done an outstanding job of pursuing substantive answers to these questions. We also recognize that the neurobiology of mental processes comprises only one component among a fertile panoply of considerations of the field of neuropsychiatry, all of which have been richly represented in the Journal during its first ten years.

Beginning with this issue of the Journal, a new department entitled "Windows to the Brain" will appear on a regular basis. Edited by neuropsychiatrist Robin A. Hurley, M.D., neuroradiologist L. Anne Hayman, M.D., and neuroscientist Katherine H. Taber, Ph.D., the new department will contain a broad range of images and computer graphics that relate to neuropsychiatry. Placing special emphasis on images that demonstrate new-onset neuropsychiatric symptoms in specific patients, the editors will discuss what is revealed and not revealed by these images. Additionally, the editors invite submissions of images (and corresponding texts) to be considered for inclusion in their section and on the cover of the Journal.

Beginning in 1999, the American Psychiatric Press plans to launch an online edition of the Journal. In collaboration with Stanford University's HighWire Press, the online edition of the Journal will be available to all subscribers and members of the American Neuropsychiatric Association at no additional charge. The online edition will be accessible via the Internet and will include the full text of all the articles published in the Journal, including all tables and figures. The text of articles will be searchable and may be downloaded to the hard drive of your computer. Image files of published articles will also be made available in PDF format, so that readers can print out articles in the format that appeared in the hard-copy Journal. The references of the articles will be linked directly to the citations and abstracts that appear in medline/PubMed, and this will enable the reader to move from the reference list of a Journal article to the abstract, index citation, and related articles in medline/PubMed.

Although this is still in the developmental stage, we are presently working on a plan to "publish" some Journal articles online only. A number of "online-only" articles will not appear in the print version of the Journal, but all articles in the print version will appear in the online version. This format will broaden the publishing scope of the Journal by allowing publication of longer, more graphically rich articles. The high cost of publishing color brain images and the high costs associated with paper printings and mailings of long articles would be obviated by the online modality. Of course, the high peer-review and editing standards for all published articles—whether in print or online—would be maintained. The Journal has had an excellent track record of "rapid review" of submissions of original research when this has been specially requested by the authors because of the timeliness and/or importance of the information. Often, for "rapid-review" requests, we have been able to have an article thoroughly reviewed by three peer reviewers, extensively revised based on these reviews, and in print within six months of the initial submission. Our reputation of being able to accomplish this without affecting the quality of the peer review has attracted many outstanding submissions. We anticipate that an "online-only" version of Journal will be able to reduce further the time from submission to "publication" (online) by an additional fifty percent.

Additionally, we are planning to implement other new opportunities that will be facilitated by technological advances. These include online submission of articles; paperless peer review of submissions; research alerting and current contents alerting of our readership regarding emergent and critical issues in neuropsychiatry; and cross-journal searching with other psychiatry journals, including the American Journal of Psychiatry, Psychiatric Services, and other American Psychiatric Press—published journals. All of these services will be provided at no additional cost to our subscribers and to members of the American Neuropsychiatric Association.

Ten years ago we concluded our initial editorial with our goals and hopes for the newly minted Journal. Only you, the reader, can determine whether or not these aspirations have been achieved. We also expressed our confidence in the power and potential of the field of neuropsychiatry. This remains unchanged:

It is the hope of the Editors and staff of The Journal of Neuropsychiatry and Clinical Neurosciences to provide a journalistic forum wherein both the leading scientist and the practicing clinician can participate and remain current in what we anticipate to be a renaissance in neuropsychiatry. This renaissance will not only enhance the efficacy and integrity of the fields of psychiatry and neurology but also will have even broader implications. For the silver lining of the scourge of neuropsychiatric illness is that these devastating diseases provide both the impetus and the substrate whereby we can explore ourselves. Through understanding Alzheimer's disease, we will eventually gain vital insights into the minute particles of matter and complex spatial arrangements that regulate unimpaired memory and learning. Through our neurobiologic investigation of bipolar illness, we will gain vital insights into the chemistry and physics of healthy feelings, temperament, and mood. It is thus one of life's bitter paradoxes that through the painful and disabling lesions treated by psychiatrists and neurologists, we are discovering ourselves. In the course of such discovery, we will ultimately not only approach relief from illness, but we may also free ourselves from the limitations—ranging from anxiety to aging—that have been accepted for millennia as the human condition.

Yudofsky SC, Hales RE: The reemergence of neuropsychiatry: definition and direction. J Neuropsychiatry Clin Neurosci  1989; 1:1—6
Kandel ER: Genes, nerve cells, and the remembrance of things past. J Neuropsychiatry Clin Neurosci  1989; 1:103—125
Kandel ER: A new intellectual framework for psychiatry. Am J Psychiatry  1998; 155:457—469


Yudofsky SC, Hales RE: The reemergence of neuropsychiatry: definition and direction. J Neuropsychiatry Clin Neurosci  1989; 1:1—6
Kandel ER: Genes, nerve cells, and the remembrance of things past. J Neuropsychiatry Clin Neurosci  1989; 1:103—125
Kandel ER: A new intellectual framework for psychiatry. Am J Psychiatry  1998; 155:457—469

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