Virgin London Marathon                                                                                                        26 April 2015
Dr Hesham Elnazer

I am a senior registrar (ST6) in Neuropsychiatry at St George’s Hospital, London. I am writing a DM in clinical Neurosciences at the University of Southampton focusing on Anxiety disorders and associated neural, endocrine, paracrine and autocrine disturbances. I will be running the 2015 London Marathon raising money for MHRUK and Mind.


Psychiatry and Neurology used to be practised jointly up until the nineteen sixties. Psychiatry since then lost most of its physical components with psychological and social theories predominating.

Recently, there has been an increasing Interest in emphasising the medical grounding of psychiatrists. The progress in scientific underpinnings of the recent advances in neural sciences, psychopharmacology, physiology, psychometric testing and therapy have transformed the subject in the past few decades.

Research evidence from the last century has shown that our mental life has its roots in the brain. Brain and mind are argued not to be discrete entities but rather different ways of looking at the same system. Conceptualizing brain and mind as two ends of a continuum would enhance further and more global understanding of aetiology and interaction between brain and environment. This will promote a more refined nosology of mental illness to emerge and improve treatment and rehabilitation strategies.

The advances of translational research and neuroimaging suggest that -In the future- psychiatrists may be able to use quantitatively analysed brain scans and other biomarkers as well as their own clinical assessment and rating scales to stratify patients in terms of clinically meaningful outcomes. This would allow psychiatrists to design more specific management plans to meet the needs of each patient.

Psychiatry and Neural science has the task of understanding the mental processes by which we perceive, act, learn, remember and how the brain produces the remarkable individuality of the human action. Modern Psychiatry requires psychiatrists to operate out of their comfort zone in embracing research developments. We owe it to our patients to deliver on the promises which modern neuroscience offers. Unravelling the intricacies of the human brain is meaningless if we continue to employ 20th-century clinical practice.

The inherent complexity of mental illness makes this more difficult than in other fields of medicine, requiring more to be invested in translating research and in training. More resources and fund raising are needed. But the reward of transforming the lives of our patients is well worth it.