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Neurobiological Formulations: Integrating Clinical and Biological Psychiatry

Received April 24, 2006; revised September 12 and December 13, 2006; accepted January 10, 2007. The authors are affiliated with the Columbia College of Physicians & Surgeons - Department of Psychiatry, at New York State Psychiatric Institute, 1051 Riverside Drive, Box 93, New York, NY 10032

OBJECTIVE: The authors describe a pilot program allowing psychiatric residents to participate in neurobiological evaluations of patients with Axis I disorders. The program aimed to familiarize residents with available tools for assessing cognitive and neuroanatomical abnormalities in psychiatric patients and to foster greater interest among residents in correlating psychiatric symptoms with abnormalities in neural structures and pathways. METHODS: Residents meet weekly with a faculty mentor to plan and construct a neurobiological formulation. Residents review the salient literature on the Axis I condition present in a patient of their choosing. The patient undergoes neuroanatomical, physiological, and cognitive testing relevant to his disorder. The resident then integrates the findings from this testing with the patient’s clinical presentation. Using a questionnaire, the authors obtain feedback from residents based on residents’ experiences with this didactic program. RESULTS: Residents felt they obtained a greater appreciation and understanding of the relevance of neuroanatomical and neurophysiological abnormalities and testing in clinical psychiatry. The project was well received and residents rated it highly for its educational value. CONCLUSION: Neurobiological formulations offer a new educational method to foster knowledge and interest among psychiatric residents about the importance of neuroscience in clinical practice.

Key Words: Curriculum Development • Neuropsychiatry • Neuroscience • Psychopathology

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