Relearning the epistemology, history, and future of neuropsychiatry

Abstract

Neuropsychiatry is a transdisciplinary field at the intersection of neuroscience, psychiatry, neurology, and humanities. Despite this strategic position, a comprehensive framework is still needed to bridge these domains. This review examines the historical evolution of how neurological, mental, and neuropsychiatric symptoms have been conceptualized, from antiquity to contemporary models, using the brain–body dilemma as a guiding thread. This historical analysis provides the epistemological and ontological foundations of neuropsychiatry, which are then connected with current definitions to critically assess the field's persistent tensions. Building on this foundation, a renewed paradigm is proposed where a crosstalk between them is enabled, grounded in deep phenotyping, dimensional research frameworks [e.g., Research Domain Criteria (RDoC), Hierarchical Taxonomy of Psychopathology (HiTOP)], and integrative models linking biological, psychometric, social data, and subjective experience. Special attention is given to a “subjectomic” layer that aims to systematically incorporate lived experience. Finally, reforms in education, clinical practice, and research are advocated to foster this conceptual reorientation, aiming at interdisciplinary collaboration and advancing patient care.