With the subspecialisation of psychiatry in the UK, clinicians may encounter problems at the interface between specialties. This article focuses on the interface between general adult psychiatry and behavioural neurology/neuropsychiatry. Important interface issues include the identification of psychiatric symptoms in patients with organic brain pathology and the remit and organisation of general and specialist services. Options for optimum cooperation are presented alongside practical examples of clinical issues of neuropsychiatric relevance.

Akathisia is a common and distressing side-effect of antipsychotic medication. The treatment of this condition is difficult and options are limited. This review of the literature was performed to develop an evidence-based algorithm for the management of antipsychotic-induced akathisia. There is limited high-level evidence to support the use of anticholinergics. Centrally acting β-adrenergic antagonists are potential treatments, although their use is limited by troublesome side-effects. Long-acting benzodiazepines and mirtazapine are potential well-tolerated treatments for the acute management of akathisia.

Psychiatry faces a number of external and internal challenges. At the heart of its difficulties is an identity crisis and attempts to resolve this have so far split the specialty. British psychiatry has in recent years taken an increasingly ‘neurophobic’ stance. This article argues that, despite the current situation, opportunities remain for a medicine of the mind to thrive. Neuroscientific advances in our understanding of psychiatric disorders need to be made more explicit in training and in the structure of mental health services.