Assuntos
Pesquisa Biomédica , Apoio à Pesquisa como Assunto/métodos , Pesquisa Biomédica/educação , Pesquisa Biomédica/história , Pesquisa Biomédica/métodos , Financiamento Governamental , Promoção da Saúde , História do Século XX , Hospitais de Ensino/organização & administração , Humanos , Relações Profissional-Paciente , Apoio à Pesquisa como Assunto/história , Estados UnidosRESUMO
OBJECTIVE: This article examines the historical basis for the divergence of neurology and psychiatry over the past century and discusses prospects for a rapprochement and potential convergence of the two specialties in the next century. METHOD: The author presents a brief historical overview of developments in neurology and psychiatry from the late 19th century. The histories of research and prevailing scientific opinion on two neuropsychiatric disorders, Alzheimer's disease and Tourette's syndrome, are compared to illustrate the effects of viewing a disease process from, respectively, the neurologic/organic and psychiatric/functional perspectives. RESULTS: Research on Alzheimer's disease, because of its early pathologic demonstration, moved rapidly toward identification of associated synaptic abnormalities and genetic mutations. In Tourette's syndrome, the absence of evident brain pathology resulted in vacillation between organic and functional explanations and persistent controversy about the nature of the illness. CONCLUSIONS: Neurology and psychiatry have, for much of the past century, been separated by an artificial wall created by the divergence of their philosophical approaches and research and treatment methods. Scientific advances in recent decades have made it clear that this separation is arbitrary and counterproductive. Neurologic and psychiatric research are moving closer together in the tools they use, the questions they ask, and the theoretical frameworks they employ. The interests of neurology and psychiatry converge within the framework of modern neuroscience. Further progress in understanding brain diseases and behavior demands fuller collaboration and integration of these fields. Leaders in academic medicine and science must work to break down the barriers between disciplines.
Assuntos
Neurologia/história , Neurociências/história , Psiquiatria/história , Doença de Alzheimer/história , Encéfalo/fisiologia , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Processos Mentais/fisiologia , Modelos Biológicos , Modelos Teóricos , Neurologia/tendências , Neurociências/tendências , Psiquiatria/tendências , Integração de Sistemas , Síndrome de Tourette/históriaRESUMO
Academic-industrial collaborations and technology transfer have over the past 50 years played an increasingly prominent role in the biomedical sciences. University partnerships with industry can expedite the availability of innovative drugs and other medical technologies, bringing both important public health benefits and a source of income for universities and their faculty through a variety of financial arrangements. However, these relationships raise ethical concerns, particularly when research involves human subjects in clinical trials. Lapses in oversight of industry-sponsored clinical trials at universities, and especially patient deaths in a number of trials, have brought these issues into the public spotlight and have led the federal government to intensify its oversight of clinical research. The leadership of Harvard Medical School convened a group of leaders in academic medicine to formulate guidelines on individual financial conflicts of interest. They and other groups are working to formulate a national consensus on this issue.
Assuntos
Pesquisa Biomédica , Indústrias , Centros Médicos Acadêmicos , Pesquisa Biomédica/história , Comportamento Cooperativo , Guias como Assunto , História do Século XX , Humanos , Indústrias/história , Transferência de Tecnologia , Estados UnidosAssuntos
Centros Médicos Acadêmicos/organização & administração , Conflito de Interesses , Indústria Farmacêutica/organização & administração , Relações Interinstitucionais , Apoio à Pesquisa como Assunto/normas , Centros Médicos Acadêmicos/normas , Indústria Farmacêutica/normas , Docentes de Medicina , Estados UnidosAssuntos
Conflito de Interesses , Apoio à Pesquisa como Assunto/ética , Centros Médicos Acadêmicos/economia , Centros Médicos Acadêmicos/ética , Tecnologia Biomédica/economia , Tecnologia Biomédica/ética , Conflito de Interesses/economia , Humanos , National Institutes of Health (U.S.)/economia , National Institutes of Health (U.S.)/ética , Apoio à Pesquisa como Assunto/economia , Estados UnidosRESUMO
Over the past 50 years, academic-industrial collaborations and technology transfer have played an increasingly prominent role in the biomedical sciences. These relationships can speed the delivery of innovative drugs and medical technologies to clinical practice, creating important public health benefits as well as income for universities and their faculty. At the same time, they raise ethical concerns, particularly when research involves human subjects in clinical trials. Lapses in oversight of industry sponsored clinical trials at universities, and especially patient deaths in a number of trials, have brought these issues into the public spotlight and have led the federal government to intensify its oversight of clinical research. The leadership of Harvard Medical School convened a group of leaders in academic medicine to formulate guidelines on individual financial conflicts of interest. They and other groups are working to formulate a national consensus on this issue.