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Faculty Spotlight: Kim Johnson, MD

Tuesday, March 13, 2018

Distinguishing between mental illnesses such as depression and neurological conditions, such as dementia or Alzheimer's disease, is difficult in many geriatric patients, both because symptoms of these conditions often overlap, and because the conditions often coexist. Kim Johnson, MD, works in this intersection between disciplines. In this week’s Faculty Spotlight, Johnson talks to us about the rewards and challenges in working with this patient group as well as the need for greater collaboration and fewer boundaries between the fields of neurology and psychiatry.

What are your responsibilities within the Neurology Department? What does your work with the Bryan Alzheimer’s Disease Research Center involve?
I work two days a week in the Memory Disorders Clinic on Morreene Road, two days a week in a Geriatric Psychiatry Clinic and one day seeing research subjects in clinical trials. My average day is focused on clinical care. I also work with Jim Burke, MD, PhD seeing patients who are participating in clinical trials for Alzheimer’s disease.  

How did you first get interested in working with elderly patients with psychiatric and neurologic conditions? What do you enjoy most about this work?
I knew I wanted to work in geriatric psychiatry before I started residency but my interest in the overlap between psychiatry and neurology started as a Duke Psychiatry Resident working in the VA Movement Disorders Clinic with Burt Scott, MD, PhD. That’s when I realized that psychiatry and neurology are not two separate disciplines, especially for geriatric patients who have neurodegenerative disease. During my psychiatry fellowship I was further exposed to neurocognitive disorders and then I was hooked. I found a specialty that combines geriatrics, cognition/memory, behavior/mood and movement disorders all in one. I enjoy working with this patient population for the intellectual challenge but also for the reward of dealing with the complexity of their needs and helping them live the last part of their life with satisfaction.  

How do your backgrounds in psychiatry and neurology complement each other in your work?
I believe we are increasingly discovering that the split between medical specialties and psychiatry is no longer sustainable, and especially so with neurology. In my specialty, neurodegenerative diseases, when the brain is degenerating every aspect of brain functioning is affected, physical and mental. A study showed that neurologic disease affects about 15% of acute and 70% of chronic psychiatric patients. Likewise psychiatric illness affects many patients with stroke, MS, epilepsy, and neurodegenerative diseases.

What solutions do you see to bridging or eliminating the gap between neurology and psychiatry? What obstacles are currently preventing this?
Continued clinical and research collaboration between psychiatry and neurology would assist with bridging the gap. I think many neurologists and psychiatrists who treat chronic disease are interested in support from one another. Ideally patients would benefit most from a neuroscience center that housed neurology, neurosurgery, psychiatry and psychology in the same location.

What passions or hobbies do you have outside of the Department?
I like to spend time with my family and enjoy the outdoors.   

Johnson poses with her husband and son after a hockey game.