Eric Taylor - Developmental Neuropsychiatry

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Library of Congress Control Number: 2020949250

ISBN 9780198827801

eISBN 9780192562852

DOI: 10.1093/med/9780198827801.001.0001

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To the reader

Multi pertransibunt et augebitur scientia

(Many will journey through, and knowledge will be increased)

Daniel xii 4; Francis Bacon, Novum Organum

The world of the mental health disciplines has come through some remarkable changes. My first experiences, in the early 1960s, were in an era of institutional treatment and care in the UK. Sometimes, this was horribly cruel; occasionally, kind and visionary. Its replacement, by normalizing community programmes, was very necessary and welcomebut is not yet complete. Recent years have seen starvation of services in the UK for child mental health, specialist education, social care, and community resources such as day centres.

Nevertheless, there is much to admire. Most of those with intellectual disability, epilepsy, or autism have lives that are much less constrained by isolation and segregation than they used to be. Many of those with attention deficit hyperactivity disorder (ADHD) are treated with compassion rather than coercion. Guideline developments have encouraged the use of interventions with evidence for value. The lessons of multiple morbidity are familiar to many, especially those working in the fields of intellectual disability.

At several points in my professional life, I have wished for a book such as this. When moving into a new sphere of clinical work, I have looked for unified accounts of the psychiatric, psychological, neurological, medical, social, and educational issues guiding clinical understanding. When starting on a new line of research enquiry, I have sought accounts that would give an appreciation of reliable knowledge together with acknowledgement of what is not yet securely known. I have therefore tried to provide introductory information about the neuropsychiatric conditions themselves, the neurological and genetic influences that can impact psychiatric presentations, and the social and personal contexts in which they unfold.

It is not, however, the book I would have written back then. Modern understanding recognizes that these neurodevelopmental disorders are complex, variable, dimensional, overlapping, and frequently coexistent. I have tried to do justice to this. The book includes short accounts of the typical development and pathology of some key functions whose alterations can underlie some forms of psychopathology. These altered functions, however, do not crystallize into currently demarcated diagnostic entities, but can be influenced by a variety of brain changes and can characterize several types of behavioural and emotional upset.