One of the big criticisms people have of psychiatry is the lack of empirical testing involved in the diagnosis of mental illnesses and antipsychiatrists seem to hang their hats on this lack of biological testing. But finally there is an approved brain scan that stands in the face of this critique. Finally, there is an FDA-approved brain scan to be used in the diagnosis of a mental illness.
FDA-Approved Treatment in the Diagnosis of ADHD
In this case, it is the diagnosis of attention-deficit/hyperactivity disorder (ADHD). A few years back I was surprised to learn how clear the brain evidence was for ADHD and now this clear evidence is being used to facilitate diagnosis. According to Time Magazine,
The Food and Drug Administration (FDA) approved Neba Health’s device for children aged six years to 17 years. It relies on electroencephalogram (EEG) readings, which track electrical impulses released by active nerves. The test lasts 20 minutes and records the frequency of impulses emitted every second. By studying the resulting wave pattern, doctors can determine with relative confidence whether the child has ADHD . . .
Diagnosing and Treating Mental Illness Using Brain Scans
And rest assured this is just the first brain scan to be used in the diagnosis of mental illness. In my lifetime I believe we will have tests for depression, bipolar disorder, autism and schizophrenia. It’s not easy to develop these tests, but over time they will come. Tests using functional magnetic resonance imaging (fMRIs) are being developed right now to diagnose these other illnesses.
And soon these brain scans will also be able to be used in the assessment of the treatment of mental illnesses as well (assessing how well mental illness treatments are working and ascertaining which treatment would be best). According to researchers:
“I am most interested in us[ing] resting-state fMRI to really examine the effects of treatment,” says Posner. He also published a paper in JAMA Psychiatry last spring showing that antidepressants successfully quieted hyperconnectivity in the brains of individuals with chronic depression.
That trial compared brain scans from 32 people with depression with those from 25 healthy counterparts and confirmed that the former group had more activity in what is known as the default mode network, a collection of disparate brain regions that makes up the baseline, or default level of brain activity necessary to keep a body functioning. When a person performs a mental task, this default network is suppressed. But in the depressed patients, this network was overactive . . .
The patients with depression were then given a 10-week course of either the antidepressant Cymbalta (duloxetine) or a placebo. At the end of the trial, patients who received the drug showed similar connectivity patterns to those seen in healthy individuals, but the depressed participants who received placebo did not . . .
Limitations of Brain Scans in Diagnosing Mental Illness
Naturally, there are limitations to this approach. First off, there is always the problem of a false result from a brain scan – and, of course, there is a margin of error on brain scans, just like on every other test. That is why the FDA has said the above ADHD test should be used in conjunction with medical and psychological evaluations. Brain scans are more an adjunctive tool right now. We’re not sophisticated enough to rely on them totally (but that will come).
The other limitation that’s clear to me is cost. Many people can’t afford to send their child for an expensive brain scan to diagnose a mental illness and even if everyone could afford it, there would be a shortage of equipment with that kind of demand. So, certainly this test is out of reach for many.
More on why brain scans for mental illness matter and why they don’t.
Finally, Brain Scans for Mental Illness
Nevertheless, this is a major advancement in the diagnosis of mental illness. I’m thrilled about it. It doesn’t help me personally, but it does lend credence to every one of us who knows and talks about mental illness being a biological illness.
Yes… I’ve never heard of you, ever, anywhere (and frankly I have no clue what misfortune brought me here), but (1) your anonymity is showing, because far more knowledgeable people than you (scads of them) would quite literally tear all your pompous diatribe to shreds. (2) I need to catch myself here, not going overboard of my anger at such ignorance, for you may be sincere in your thoughts. I tend to go for the jugular when it comes to deeply held beliefs.
(3) May I suggest you (1) read Dr. Kelly Brogan’s book, ‘A Mind of Your Own’ which completely and totally derails to smithereens the entire, total psychiatric community. My review is the top rated critical review (at least it was the last time I looked)
(4) Then spend time learning about “intentional peer support”. It’s international, unlike anonymous you.
(5) Take a trip through Mary Ellen Copeland’s WRAP. This may be where you need to spend your time, doing your own recovery. You see, peer support works. WRAP is 19 and international (unlike you).
(6) Learn about ACEs. Read ‘Childhood Disrupted. Great writer.
(7) For virtually everything else, go read madinamerica.com. They know their stuff.
Your blog demonstrates that – yes, crappy untruths can be written. Mpeople who’ve lived through paychiatry’s toxicity and society’s stigma most assuredly do NOT need to be sent down a dead end via blogs such as yours.
FAILED!!!!!
I hope to start a new thread to get further insight on Bipolar Depressant Disorder. My son’s mental health issues became obvious at 15 and he has struggled ever since. He is now 19. He has had various diagnoses/labels -anxiety , depression, low self esteem and the label that is most used by his therapists and psychiatrists is bipolar depressant. I see very little on this and want to get a more thorough understanding of this particular diagnosis. Any insight welcome. Thanks
Hi
I wonder if you guys saw reports on a brainscan able to distinguish between biopolar disorder and boderline personality disorder?
An easy-read version: http://www.zmescience.com/research/brain-scan-biological-differences-mental-disorders-432532/
The paper (paywalled): http://www.nature.com/mp/journal/vaop/ncurrent/full/mp201322a.html
Natasha,
Actually this device was cleared for marketing, not exactly ‘approved’ per say.
Ref: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm360811.htm?source=govdelivery
The device will have to face ‘scientific’ scrutiny (Replication and accuracy) before any particular organization such as the APA actually adopts it in their DSM manual.
Currently the DSM5 Field trials showed a diagnostic reproducibility for ADHD diagnosis of only 61%.
While a diagnostic test would certainly improve diagnosis, the condition itself is still subjective. Many things can cause abnormal EEG readings, and if the device can’t tell ADHD apart from Anxiety or patients on drugs for non-psychiatric problems then the test might be nerfed.
This isn’t the first time I’ve heard of ‘Diagnostic” tests, for example fMRI being used for mental illness (with poor or non reproducible results), but it’s the first time I’ve heard of a diagnostic test being modified specifically for Mental illness.
EEG has extremely limited usefulness. QEEG has mostly replaced it’s use. Quantitative EEG records Voltage, Amplitude, and frequency, while EEG alone only measures frequency. I’m sorry to say the claim sounds somewhat preposterous, specifically because the children in the study were drugged with psychotropic medications. It’s already widely understood the drugs produce their effect by causing changes in brain activity. The presence of feedback mechanisms makes it impossible for a drug to ‘correct’ a Chemical imbalance if such a thing did exist. ADHD Stimulant drugs are now understood to produce the same effects in normal people as ADHD children, subjectively as well as on QEEG. The same for antidepressants and other drugs, they physically can not normalize brain activity on a QEEG or EEG, hence an abnormal EEQ is detected.
I think the device probably just flagged children that had previously received drugs, or were currently on drugs… While nervous system dysfunction is objective, it’s doesn’t mean ADHD was the cause.
It’s distressing to see EEG used to diagnose anything since QEEG was invented… There is literally no advantage whatsoever as it simply collects less information. It’s like taking a photo comprised of only two colors when you could have used all of them.
I am wondering whether the scan could have two identical “diagnostic results” from two people. Both whom would be “considered” type II Bipolar.
The big “however” might be that one individual has never been treated for it because it did not physically or mentally get triggered, thus, never really experiencing the illnesses in a way that the other one does.
This will probably be used in court cases wherein a defendent claims that he/she is insane.
This is nice to know. I believe it is a step in the right direction anyway. So many mental health professionals make it very difficult for me to believe they understand the illnesses they have read about in texts. I think when they get a handle on the brain, we will have a much better/healthier way to cope with mental challenges.
THE CLAIM: Mental illness can be diagnosed with brain scans.THE FACTS: Currently the technique might be able to diagnose people with a single, unambiguous, chronic illness but not tougher clinical cases.
I was put through three sleep deprivation EEGs in 1990 at age 15 to help confirm my mental illness. How is this device different than an EEG? (Disturbingly enough, one thing my EEGs supposedly “confirmed” was that my haloperidol was working, a drug which mainstream psychiatry now admits is “neurotoxic” and causes extensive brain damage. Perhaps someday I will be able to receive a scan that will determine how much brain damage my haloperidol caused.)
Glad to hear there is a brain scan that can help diagnose ‘mental illness’. That might sort out the confusion between two psychiatrists and one social worker who can’t decide which box I fit into. Yes, three ‘experts’ who can’t agree. Goes to show what a joke the mental sickness system really is.
A EEG attached to the scalp and ran for 20 minutes to track electrical impulses in children aged 6-17 years of age definitively diagnoses ADHD?
A EEG attached to the scalp and ran for 20 minutes, often cannot detect or definitively diagnose seizures – which are electrical impulses… HOW in Hades can it definitively diagnose ADHD by tracking impulses?
They took children 22 ALREADY diagnosed with ADHD, attached the EEG as well as those 20 children NOT ALREADY diagnosed with ADHD.
In that MI is subjective to start… that is, a psychiatrist in one area says “No” whereas a psychiatrist in another area with same info as the 1st will say “Yes”… it’s interesting that they took those supposedly diagnosed with and compared them to those supposedly not.
Also.. those with other neurological disorders affecting the focus, attention and judgment of an individual would most likely have the same and/or similar result when scanned. Did they test the KNOWN children against those with other Neuro disorders?
I want desperately for someone at some point to scan the brain or do a medical test and with absolute certainty say “MENTAL ILLNESS” and as to which one. That hasn’t happened yet and this isn’t absolutely certain.
The FDA did approve but the FDA also approves BC pills that are removed from the market, Mesh that is removed from the market, etc. The FDA approval is not an absolute given.
MORE studies need to be performed on a wider range of individuals… do NOT use those already psychiatrically evaluated and/or diagnosed with… put some who have “other” neuro issues with similar or same difficulties and then see if it says definitively “mental illness and it’s called ADHD.”
The study reported was SPECIFICALLY for ADHD because they were “looking” for ADHD….
and the study that involved those with Depression vs those diagnosed without and the result after having taken a anti-depressant also does not impress… any substance that you take which is created and generated to alter the brain in some way would show some result and/or differential, after a period of time
The stupidity of such a conclusion from such a scan is woeful. In centuries past scans were done successfully to locate the mentally and spiritually inferior/defective, external scans that is, to see if the persons had dark skin or were female. Of course the results were just as clear, black n white as this scan (pun intended). This methodology is just stupid and small minded. anyone who promotes, protects or falls for this kind of fascist engendering quasi science is the same kind of person the righteous have struggled against for eons to liberate the world from bigotry, sexism, oppression and racism. This proves nothing but the mind works in different ways under different conditions, just like the adrenal glands, sexual organs, digestive system…etc all normal processes reacting to different stimulii.
these are not stupid or small minded. do more research on scans today and you’ll see they’re more advanced now
This is excellent news. Here is hoping scans to diagnose mental illness is just around the corner. Maybe then some people won’t have to attempt suicide to get someone to believe they are ill!
This could also help people with bipolar disorder, off-label. It’s plain fact that most bipolars have a lot of ADHD symptoms. Toss a coin as to whether a particular psychiatrist will diagnose the same patient as bipolar with comorbid ADHD or just diagnose her as bipolar and consider her ADHD symptoms to be “rolled into” that bipolar diagnosis.
Because ADHD involves abnormalities in the executive function areas of the frontal lobes, for a bipolar with ADHD symptoms, this can confirm that there are the telltale brain abnormalities in the ADHD area. Off-label, the differences of bipolar ADHDs from non-bipolar ADHDs can help inform diagnosis. That is, the scan can give some clues before you start hitting a particular patient with meds as to which disorder you’re looking at.
For children with early onset bipolar disorder, this approval is huge, because they frequently present with ADHD symptoms and it can be very difficult for conventional methods to tell the difference between a kid with early-onset bipolar and a kid with “vanilla” ADHD.
I was early onset, and so was my child. Fortunately for my child, I knew what to look for and was able to tell the pdoc who first saw my child which specific symptoms I was seeing that distinguish between the disorders. Most parents don’t have the background to do that. This test, used right, can help build a body of data that will help early onset kids without the advantage my kid had.
This test also has the potential to help isolate adverse cognitive side-effects of medications by the _other_ areas of the brain as they show up in the “after” scans. One of my friends is at the bleeding edge of some of the current brain research, and some of what he says about new developments in how various drugs affect cognition is heartening.
Basically, looking at your brain work they can tell how hard you’re working to solve a task. When you take a normal person (or lab rat) and put them on cocaine, those areas of the brain work much harder at tasks that are simple for the person (or rat) when not on cocaine. They can *see* the effect of the drugs making it hard to think. Since I had a cognitive dulling side-effect on a med I used to take, I know how hard it is to present that to providers as a problem, and what a big problem it is. It’s difficult to say, “Help, something’s terribly wrong, suddenly I’m only average intelligence.”
Worse, a drug that dulls you may be making you dumb and also impeding you from recognizing it–you’re too loopy to tell. Or whatever other nasty brain side-effect you may be having.
The ability of scans to track and quantify the brain effects of medication, both the good effects and the bad ones, has the potential to greatly improve treatments by helping medicine better understand the effects of these drugs throughout the brain, better understand the specific brain issues of the specific patient, and identify adverse effects better and earlier.
In plain English, the doctors will “get it right” on our meds quicker, with fewer missteps. The accumulated, precise knowledge from the people who can afford to have the scans, or who are in research studies, will give the frontline doctors better knowledge to use on patients even when they don’t have scan data from that patient. It will improve pdocs’ understanding of what questions to ask the patient and what to look for in examining the patient. Also, gene scans are cheaper than brain scans. By providing us with precisely targeted information about brain biology in the variations of mental illness, and linking subtypes to specific genes, brain scans can help us develop cheaper DNA tests that pdocs can use to make better prescribing solutions, faster, and with fewer missteps and nasty side-effects.
Also, these scans can help us in disability claims or disability discrimination claims by verifying that there actually is a brain impairment interfering with our ability to do a task as well as someone without the impairment. I have problems with tardiness and missed appointments because my brain doesn’t track time well. I have these problems even using a lot of compensatory strategies. The strategies *help*, but not enough to make me as good at those things as someone without a disability who is also trying hard. Unfortunately, the layman can’t distinguish “brain impairment” from “doesn’t care, making excuses.” Realistically, there are people out there who don’t care and are great at making excuses. A test that can distinguish us from them would be a big plus in crafting reasonable workplace accommodations and with states’ departments of labor’s offices of rehabilitative services. McJobs usually legitimately require exceptional timeliness. Some more skilled jobs have room to be more flexible as an accommodation. Establishing disability instead of carelessness can be key in getting funding for job/career training.
Thanks, Natasha. You’ve made my day. This is *very* good news for us.
It is always interesting when you are faced with something that you intuitively feel is wrong. And this is my response to this posting – not that the brain does not register what is happening in the mind but the implication that this confirms the existence of a mental illness and therefore medical type interventions. My experience with seriously disturbed clients is that they can be helped without medicalising and pathologising. Yes trauma relief may be necessary and they need to be empowered to get control of their life and emotions but they are not ill. And how they are is the natural response to a life that is not working for them.
Is a twisted ankle an illness despite being able to be registered on an X ray? Well yes technically, but not really. All that is needed is rest and perhaps careful physiotherapy. Might a lot of mental problems be closer to a twisted ankle than to say cancer or malaria?
I don’t get why you can’t see that it at least shows there is something there that’s wrong with the brain. the images are pretty clear; I don’t know if it can diagnose but it definitely shows some kind of disorder in the brain