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

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), autism, Asperger syndrome, and so on.

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 borderline personality disorder or schizophrenia.

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

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 be identified and treated.

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

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.

**II**

**Section 5**

**Section 6**

INA Early Intervention for Babies at Risk

*Caroline Barmatz and Omer Bar-Yosef*

Early Intervention **119**

**Chapter 7 121**

Systems Biology Perspectives **133**

**Chapter 8 135**

*by Hagit Friedman, Marina Soloveichick, Amir Kushnir, Chava Kasher,* 

Systems Biology Perspectives for Studying Neurodevelopmental Events

*by Elodie Mathieux and Marco Antonio Mendoza-Parra*

We have a long way to go before we achieve the vision set forth by Thomas Insel, former director of the National Institute of Mental Health in the United States (NIMH), who stated that future diagnosis in psychiatry should be based on biomarkers, neuroimaging and laboratory tests [2–4]. This is only aspirational at this point.

The first chapter of this book sets out the future of psychiatry in relation to neurodevelopmental disorders and what is basically a new understanding of psychiatry in recent decades. Other chapters address topics such as the early recognition of schizophrenia, early intervention for babies at risk of neurodevelopmental disorders, epilepsy, and the genetics of ataxia telangiectasia. Finally, this book examines the complex issue of systems biology and neurodevelopment.

> **M. Fitzgerald** Professor, Department of Psychiatry, Trinity College, Ireland

> > **V**

[1] Fitzgerald M. Schizophrenia and autism, clinical overlap and difference. Clinical Neuropsychiatry.

[2] McCarthy SE, Makarov V,

Kirov G, Addington AM, et al. Micro duplications of 16p11.2 are associated with schizophrenia. Nature Genetics.

[3] Craddock N, Mynors-Wallis L. Psychiatric diagnosis: Impersonal, imperfect and important. British Journal

of Psychiatry. 2014;**204**(2):93-95

[4] Craddock N, Owen M. The Kraepelian dichotomy- going, going, but still not gone. British Journal of Psychiatry. 2010;**196**(2):92-95

2012;**10**(4):171-176

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