THE CONTRIBUTION OF NEUROPSYCHOLOGY TO PSYCHIATRY

Objective: Neuropsychological test data are applied with increasing fr equency in research studies and clinical practice in psychiatry. This article addresses three popular assumptions about neuropsychological t est data and describes the limitations and contributions of neuropsych ological assessment of patients with psychiatric disorders. Method: Al l research articles from major journals in psychiatry and clinical psy chology since 1991 that focused on neuropsychological assessment of ps ychiatric patients were reviewed. Other journals and earlier studies w ere reviewed selectively. Results: Neuropsychological test data have m ade significant contributions to the development of hypotheses about a bnormal brain structure and function in patients with psychiatric diso rders, yet many findings from neuropsychological assessments of psychi atric patients are misinterpreted. The extent to which neuropsychologi cal test data in psychiatric populations can be interpreted to reflect abnormalities in brain structure and function is frequently exaggerat ed, as is the ability of neuropsychological measures to serve as speci fic cognitive Probes in imaging studies of physiological activation. O n the other hand, the utility of neuropsychological test batteries as measures of the patterns of cognitive strength and deficit in individu als with specific psychiatric disorders is frequently underestimated. Conclusions: In addition to testing models of regional brain dysfuncti on in psychiatric disorders, neuropsychological tests can provide rese archers in psychiatry with an improved understanding of the relation b etween central cognitive impairments and symptoms and serve to identif y cognitive Predictors of course of illness, and they may provide a me thod for discriminating among heterogeneous forms of some psychiatric disorders: Clinically, neuropsychological test data can be used to dev elop treatment strategies tailored for an individual's specific cognit ive strengths and deficits.