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Am J Psychiatry 1995; 152:6-15
Copyright © 1995 by American Psychiatric Association
The contribution of neuropsychology to psychiatry
RS Keefe
Department of Psychiatry, Mount Sinai School of Medicine, Bronx, NY 10468.
OBJECTIVE: Neuropsychological test data are applied with increasing
frequency in research studies and clinical practice in psychiatry. This
article addresses three popular assumptions about neuropsychological test
data and describes the limitations and contributions of neuropsychological
assessment of patients with psychiatric disorders. METHOD: All research
articles from major journals in psychiatry and clinical psychology since
1991 that focused on neuropsychological assessment of psychiatric patients
were reviewed. Other journals and earlier studies were reviewed
selectively. RESULTS: Neuropsychological test data have made significant
contributions to the development of hypotheses about abnormal brain
structure and function in patients with psychiatric disorders, yet many
findings from neuropsychological assessments of psychiatric patients are
misinterpreted. The extent to which neuropsychological test data in
psychiatric populations can be interpreted to reflect abnormalities in
brain structure and function is frequently exaggerated, as is the ability
of neuropsychological measures to serve as specific cognitive probes in
imaging studies of physiological activation. On the other hand, the utility
of neuropsychological test batteries as measures of the patterns of
cognitive strength and deficit in individuals with specific psychiatric
disorders is frequently underestimated. CONCLUSIONS: In addition to testing
models of regional brain dysfunction in psychiatric disorders,
neuropsychological tests can provide researchers in psychiatry with an
improved understanding of the relation between central cognitive
impairments and symptoms and serve to identify cognitive predictors of
course of illness, and they may provide a method for discriminating among
heterogeneous forms of some psychiatric disorders. Clinically,
neuropsychological test data can be used to develop treatment strategies
tailored for an individual's specific cognitive strengths and deficits.
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