The World Health Organization (WHO) defines neurological disorders as physical diseases of the nervous system and psychiatric illnesses as disorders that manifest as abnormalities of thought, feeling, or behaviour. In fact, however, there are longstanding unresolved debates on the exact relationship between neurology and psychiatry, including whether there can be any clear division between the two fields.
Related to this, Brandy B. sent us a figure from the blog Neuroskeptic graphing the proportion of journal articles on various disorders included in The American Journal of Psychiatry versus the journal Neurology over the past 20 years. The image is interesting from a sociological standpoint in that, as Brandy writes, “it says far more about the sociology of these fields than about which disorders can be considered neurological or psychiatric.”
While debates regarding the neurological roots of psychiatric illnesses such as depression and schizophrenia are far from settled, the graph shows that the two disciplines have maintained varying levels of intellectual authority over different disorders. Some fall clearly into one domain or the other, while others are covered in both. Depression, for example, receives more attention than mania in Neurology, despite the fact that mania often occurs alongside depression as a symptom of bipolar disorder.
The information in this graph serves as a reminder that what gets published in academic journals, and the topics over which disciplines exercise authority, are the results of social processes. Disciplines are artificial categories of knowledge, solidified through the creation of institutional structures like university departments, degree programs, and academic journals. Psychiatry, for example, didn’t emerge as a discipline until the 19th century; this emergence was rooted in a social context in Western Europe where rising numbers of people were being institutionalized and attitudes regarding the treatment of mental illness were changing. By claiming membership in disciplines based on common academic backgrounds, research methodologies, and topics of study, scholars contribute to the reproduction of these disciplinary boundaries.
The peer-review process is one facet of this social reproduction of disciplinary boundaries that is particularly relevant to the image above. Research and papers that are submitted, accepted, and funded must appeal to reviewers and conform to the criteria set out by the journal or discipline within which researchers wish to publish. In the case of neurology and psychiatry, it appears based on this graph that the peer-review process may uphold disciplinary boundaries, as reviewers for each discipline’s journal appear to favour articles on certain disorders.
The divisions between neurology and psychiatry suggested in the image above stir up lots of interesting questions not only about what we consider to be “neurological” or “psychiatric”, but more generally about the social production of knowledge.
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Hayley Price has a background in sociology, international development studies, and education. She recently completed her Masters degree in Sociology and Equity Studies in Education at the University of Toronto.
