Magazine article Clinical Psychiatry News

Imaging Deemed Unreliable in Diagnosing Mental Illness

Magazine article Clinical Psychiatry News

Imaging Deemed Unreliable in Diagnosing Mental Illness

Article excerpt

SAN FRANCISCO -- It's easy to find someone willing to take your money for a brain scan. It's a lot harder to use these scans in understanding mental illness, according to Dr. Robert L. Hendren.

"We can't really find the kind of images that can help us make the diagnosis of a mental disorder," said Dr. Hendren, director of child and adolescent psychiatry at the University of California, San Francisco. Genetic, metabolic, and other kinds of screening for bio-markers are only slightly more useful, he said at the meeting.

It still makes sense to look for biologic causes for mental illness. "Increasingly, we're finding that disorders like conduct disorder have a neurological, neurodevelopmental etiology," Dr. Hendren said. After all, brains grow and change as they interact with the environment. And physicians need better tools for diagnosing such illnesses. Signs and symptoms don't always fit neatly into the categories laid out in the Diagnostic and Statistical Manual of Mental Disorders.

So researchers have tried MRI and other approaches to look for patterns that might reveal mental illness. They have found some correlations.

And some imaging centers have leaped on these findings to market their services to families of children with mental illness. "You probably are aware of people doing that," Dr. Hendren said. "Families will pay $3,000 or $4,000 to have these scans performed and shown to them. And then they get recommendations based on a good history that aren't much different than if the scans had not been done."

The problem is that researchers have not traced any common diagnosis to a particular site in the brain. Multiple sites may be involved.

Imaging can help only in very specific instances. Among the accepted indications for MRI include microcephaly, macrocephaly, unusual head shapes, regression, or an abnormal neurologic examination. …

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