Psychiatric Annals

Guest Editorial Free

Psychiatric Implications of Neurological Disorders

Muna Irfan, MD

The fields of neurology and psychiatry have an undeniably common origin. This relationship has been historically recognized by Freud who believed that the brain is the seat of psychopathology. The overlap between these disciplines is especially evident in the realm of behavioral neurology, which does not segregate various domains of the brain, but integrates physical and mental factors for a holistic approach. With the advancements in neuroscience, a heightened need for collaboration between the two disciplines has evolved. In this issue of Psychiatric Annals, we have embarked on a journey into the realm of neuropsychiatry, as it is fairly common for psychiatrist in practice to face clinically overlapping presentations of undiagnosed neurological disorders.

The Feature article, “Neuropsychological Disorders Across the Lifespan: Overview and Implications” by Dr. David E. Tupper describes the implications of neuropsychological disorders spread across the life cycle. Through illustrative cases, the article explores important issues, concepts, and processes involved a longitudinal approach to understanding and managing neurobehavioral disorders throughout the lifecycle.

The first article, “Sleep Disorders and Dementia: From Basic Mechanisms to Clinical Decisions,” by Dr. Elissaios Karageorgiou and colleagues highlights the bidirectional relationship between sleep issues and dementia. The authors focus on early detection of sleep disorders and intervention in clinical practice to demonstrate the progression of both processes.

Next, the article “Delirium Versus Dementia: A Diagnostic Conundrum in Clinical Practice” by Dr. Ranji Varghese and myself explores the quintessential diagnostic quandary in clinical practice—the epidemiology, predisposing and precipitating factors, clinical characteristics, and diagnosis and management of the patient are reviewed to assist in clinical decision-making.

The third article, “Management of Psychiatric Features in Frontotemporal Dementia,” by Drs. Jamie Starks and Michael Rosenbloom discusses the presentation and management of psychiatric symptoms encountered in frontotemporal dementia. Not only are the clinical phenotypes of the neurodegenerative process elaborated upon, but also various pharmacological and nonpharmacological strategies addressing common neuropsychiatric symptoms observed in the spectrum are discussed.

Next, the article “Psychiatric Disease in Amyotrophic Lateral Sclerosis” by Drs. Samuel Maiser and Ezgi Tiryaki focuses on unrecognized mental illnesses, which can significantly impact the quality of life of both the patient and caregiver.

The final article, “Psychiatric Management of Huntington's Disease,” by Dr. Martha A. Nance is an apt example of the intersection between brain and behavioral pathology, thus requiring clinical acumen for detection and addressing these concerns.


About the Guest Editor

Muna Irfan, MD

Muna Irfan, MD, completed her residency in neurology at the University of Minnesota. After that, she went on to pursue her passion in sleep medicine at the Mayo Clinic (Rochester, MN). Currently, she is an Assistant Professor of neurology at the University of Minnesota, and the Site Director of Sleep Fellowship at Hennepin County Medical Center.

Dr. Irfan has a distinct interest in management of various neurological and sleep disorders. She received the “Parasomnia Section Research Award” in 2015 from the American Academy of Sleep Medicine and was nominated by her peers as “top rising star physician” in April 2017 by the Minneapolis. St. Paul Magazine.

Her dedication in raising awareness and medical education in sleep medicine is commendable, as she assiduously continues to work on various forums locally and globally. Her work toward enhanced detection of sleep disturbance in stroke patients won the Kennedy Research Symposium Award in 2017 at University of Minnesota. She is a member of the American Academy of Neurology and the Academy of Sleep Medicine. Her enthusiasm about parasomnias including rapid eye moment sleep behavior disorder, restless leg syndrome, and sleep problems in complex neurological diseases is reflected in her educational endeavors and clinical duties.

Address correspondence to Muna Irfan, MD, Minnesota Regional Sleep Disorders Center, Mail Code G8, 900 South 8th Street, Green Building, G8.220 HCMC, Minneapolis, MN 55415; email:

Disclosure: The author has no relevant financial relationships to disclose.


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