Contents



Preface

Neurodevelopmental disorders are the new psychiatry. One of the tragedies of the twentieth century, particularly in child and adolescent psychiatry and to a lesser extent in adult psychiatry and psychology, was the tradition of blaming families, especially mothers, for psychiatric problems. Tragically we had, 'schizophrenic mothers' as causes of schizophrenia and 'refrigerator mothers' as causes of autism.

These false theories caused untold distress to mothers and families. It does appear to me that attachment theorists could be in danger, using a different theory, of repeating some of these same errors and causing more unnecessary guilt among mothers.

At a clinical level I have seen many children described as having attachment disorders, who actually have classic Asperger syndrome. Asperger's is still listed in the *International Statistical Classification of Diseases* (ICD-10), but has been incorporated into autism spectrum disorders in the *Diagnostic and Statistical Manual of*

Over many years, I have observed how it is almost impossible for professionals trained in the theories of Sigmund Freud and John Bowlby to take on board the neurodevelopmental disorders of attention deficit hyperactivity disorder (ADHD),

Other disorders, including learning disability, bipolar disorder, and schizophrenia, are now recognised as neurodevelopmental. These three cause less difficulty for clinicians, although Asperger syndrome is often misdiagnosed as bipolar disorder or

All of these neurodevelopmental conditions overlap to a greater or lesser extent. They are not separate categories, that is, they are not categorised in narrow diagnos-

It is widely agreed that the current classifications in psychiatry are unsatisfactory. People have been aware for some time of the overlap between bipolar and schizophrenia, in relation to the psychotic spectrum [1]. I have quite a number of patients on the autism spectrum who developed psychosis in adult life, or indeed sooner. Overlap of conditions is extremely common and each element of the overlap must

All of these disorders have major genetic underpinnings. Indeed some genetic findings overlap between these developmental disorders with other non-overlapping

The future of psychiatry will be neurodevelopmental in large measure. Psychiatrists will focus on these conditions, while psychotherapists, counsellors and psychologists will treat mild psychiatric conditions with psychotherapeutic interventions.

tic 'boxes'. They are best seen along overlapping dimensional lines.

*Mental Disorders, Fifth Edition* (DSM-5).

autism, Asperger syndrome, and so on.

be identified and treated.

findings.

borderline personality disorder or schizophrenia.
