Sheldon Benjamin, MD, Vice Chair for Education in Psychiatry at the University of Massachusetts Medical School, was installed as President of the American Neuropsychiatric Association (ANPA) during its annual meeting held in Boston April 3-6. The 600-member organization is comprised of neuropsychiatrists, behavioral neurologists, neuropsychologists and others interested in brain-behavior relationships.
During his presidential address at the closing banquet, Benjamin spoke on “Neuropsychiatric Values and the Value of Neuropsychiatry.” Citing neuropsychiatric experience with the encephalitis lethargica (sleeping sickness) epidemic of 1916-1927, he described two neuropsychiatrists of the day worthy of emulation—Constantin Baron Von Economo and Smith Ely Jelliffe. Von Economo, working in Vienna, characterized the epidemic at the time, with careful patient examination, painstaking correlation of phenomenology with pathophysiology, and precise recording of deficits and patient outcomes. Jelliffe, a professor at Columbia University and editor of the Journal of Nervous and Mental Disease and the Psychoanalytic Review, collected and translated hundreds of case descriptions of encephalitis patients, correlating their psychiatric phenomenology with a particular involuntary eye movement called oculogyric crisis, a relationship which continues to be relevant today. Encephalitis lethargica, Benjamin said, was a paradigmatic disorder for neuropsychiatrists with many lessons for modern physicians. It caused numerous forms of mental illness that were finally understood as caused by brainstem encephalitis, yet could be slow in onset, and easily misdiagnosed. It bears some relationship to autoimmune limbic encephalitis described in the recent book, Brain on Fire, by Susannah Cahalan.
Benjamin summarized his ideas on basic neuropsychiatric values— that patients deserve an accurate diagnosis, that the physician must often draw on knowledge that bridges specialties to understand a disorder, and that treatment must follow pathophysiology. He went on to enumerate the values of neuropsychiatry to patients, trainees, healthcare systems, and the profession as a whole and encouraged the audience to advocate for increasing the neuropsychiatric knowledge of physicians, for increasing the availability of combined training in neurology/psychiatry, and for funding of fellowships in behavioral neurology and neuropsychiatry. He encouraged neuropsychiatrists throughout the United States to be at the table as accountable care organizations are organizing, and to seek ways of integrating care and collaborating with primary care physicians in the care of complex neuropsychiatric disorders. To that end he announced the establishment of a National Taskforce on Neuropsychiatry and Health Care Reform, to be chaired by Jordan Eisenstock, MD, also of UMass. “Neuropsychiatry is good medicine,” said Benjamin, and can result in more effective and efficient care for complex patients. Benjamin will serve as ANPA President until March 2015.