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This article reviews the accomplishments of psychiatric nursing—theory development, advanced practitioner rôles, family-centered care—and notes some limitations—a projected shortage of psychiatric nurses, devaluation of biological knowledge, reluctance to focus on illness. The challenges ahead for the 1990s are described with a focus on the tremendous need to integrate the biological sciences (neurobiology, genetics, and immunology) and behavioral sciences in the practice of psychiatric nursing. In the development of these issues, attention is paid to the argument raised by consumer advocacy groups that a clear differentiation exists between adjustment problems and mental illness. In a time when psychiatry is realigning itself with medical practice, it is important that psychiatric nursing become reassociated with both neurological nursing and the care ethic. This article ends with a partial list of questions for …