The Future of Psychiatry is Neurodevelopmental

**3**

**Chapter 1**

**Abstract**

neurobiology

**1. Introduction**

**2. Adult autism**

The Future of Psychiatry and

A Paradigm Shift

allows more focused treatment interventions.

*Michael Fitzgerald*

Neurodevelopmental Disorders:

A paradigm shift is now taking place in psychiatry with the emphasis on neurodevelopmental disorders with a neurobiologic emphasis and early onset including autism, ADHD, learning disability, schizophrenia and bipolar disorder. This paradigm superseded the attachment paradigm of the second half of the twentieth century with so many misguided theories such as, "blaming the mother"—the socalled refrigerated mother and the schizophrenogenic mother. The new paradigm

The future of psychiatry is neurodevelopmental. One of the tragedies of the twentieth century, more particularly in child and adolescent psychiatry, is the tradition of blaming families and particularly mothers for psychiatric problems. Tragically, we had "schizophrenogenic mothers" as "causes" of schizophrenia and "refrigerated mothers" as "causes" of autism. Even more recently, tragically, John Bowlby [1], in discussing "causal factors" in relation to autism, mentioned "inappropriate mothering". This is another mother-blaming idea. The current understanding of these disorders, intellectual disability, ADHD, autism, Asperger's syndrome, tics, etc., is a neurodevelopmental disorder with schizophrenia and bipolar disorder also being neurodevelopmental, and all have significant neurobiological inputs. Some personality disorders should also be considered as being on the neurodevelopmental spectrum. The neurodevelopmental trajectory will include the addition of more neurodevelopmental disorders, e.g.,

All diagnoses of autism have to take a developmental history from childhood, which will include persistent deficits in social communication and social interaction from the early developmental period, as well as restricted, repetitive patterns of behaviour causing clinically significant impairment in functioning (American Psychiatric Association [2]). The problem with adult autism diagnosis will include getting a relatively early history from an informant which may be a parent or other,

**Keywords:** neurodevelopmental disorders, autism, attachment disorders,

bipolar, schizophrenia and depression as the person gets older.
