Imaging may unlock new mental illness diagnosis options

October 11, 2013 by Adela Talbot

(Medical Xpress)—Imagine suffering from a mental illness and waiting up to a decade to get a proper diagnosis, all the while taking the wrong medications. This is an unfortunate reality for some patients suffering from bipolar disorder (BD) and major depressive disorder (MDD), said Dr. Elizabeth Osuch, a researcher at Western's Lawson Health Research Institute and a psychiatrist at the London Health Sciences Centre.

The problem is, diagnosis isn't an exact science, she noted, being heavily weighted on patient observation and history. BD and MDD are two commonly misdiagnosed disorders in psychiatry.

"The diagnostic criteria are inadequate for the task. They're not about pathophysiology – there's no lab tests, no imaging tests to test for these things," Osuch explained, noting psychiatrists mostly rely on set descriptions of ailments when diagnosing .

But, as with any medical condition, mental illnesses can sometimes present themselves differently, varying from patient to patient, so misdiagnosis is a frequent risk. That's where Osuch's work comes in.

In a recent test group of 30 young patients, 15 diagnosed with MDD and 15 with BD, Osuch found a biomarker in the brain of patients with BD. She imaged the brain with (MRI), looking for a region that corresponded with the bipolarity index, a diagnostic tool that encompasses varying degrees of BD.

The MRI tests revealed an activation of the putamen, a round structure at the base of the forebrain, which has a positive correlation with BD – and what could be the differentiating factor between BD and MDD.

"In young people, BD presents differently than in an older adult. Sometimes you see mixed states, so you can mistake BD for MDD," she said.

"The first thing you have to keep in mind is these illnesses present themselves in adolescents and young adults, and if someone is malfunctioning in their later high school and university years, that's messed up their life pretty seriously," Osuch continued.

This is why it is so important to get a proper diagnosis – the earlier the better – and treat the ailment appropriately from the start.

"If you treat somebody with MDD as if they have and you give them a mood stabilizer, when they need an antidepressant, you're overmedicating them and giving them adverse affects," Osuch said. The same is true when mistaking BD for MDD and prescribing an antidepressant.

Her recent study is unique in the field, as she is not looking at patient diagnoses or mood states of the individual, but instead at the dimensional aspects of the patients. She plans to continue this study with a larger sample group, looking for the same findings.

"We're looking for what really is going on here at the level of pathophysiology, to help better find these (diagnoses). What I published is one piece of the puzzle. The distinction (between BD and MDD) is really quite important and coming up with a better distinction would be great," Osuch said.

She added this is the ideal case scenario, and a possibility, in psychiatry, helping doctors to effectively and rapidly diagnose and treat patients.

"Looking to pathophysiology for diagnoses rather than descriptions would be great."

Explore further: Imaging in mental health and improving the diagnostic process

Related Stories

Imaging in mental health and improving the diagnostic process

August 15, 2013
What are some of the most troubling numbers in mental health? Six to 10—the number of years it can take to properly diagnose a mental health condition. Dr. Elizabeth Osuch, a Researcher at Lawson Health Research Institute ...

Smoking during pregnancy may increase risk of bipolar disorder in offspring

October 1, 2013
A study published today in the American Journal of Psychiatry suggests an association between smoking during pregnancy and increased risk for developing bipolar disorder (BD) in adult children. Researchers at the New York ...

A better way of estimating blood loss

March 5, 2013
Research suggests that there may be a better way of measuring blood loss due to trauma than the current method, finds an article in BioMed Central's open access journal Critical Care. The study shows that base deficit (BD) ...

Depression linked to reduced temporofrontolimbic coupling

June 6, 2012
(HealthDay) -- Patients with remitted major depressive disorder (MDD) have reduced guilt-selective temporofrontolimbic coupling between the right superior anterior temporal lobe (ATL) and subgenual cingulate cortex and adjacent ...

Order of psychiatric diagnoses may influence how clinicians identify symptoms

November 28, 2012
The diagnostic system used by many mental health practitioners in the United States—known as the Diagnostic and Statistical Manual of Mental Disorders—assumes that symptoms of two disorders that occur at the same time ...

Recommended for you

Heart rate study tests emotional impact of Shakespeare

July 26, 2017
In a world where on-screen violence has become commonplace, Britain's Royal Shakespeare Company is turning to science to discover whether the playwright can still make our hearts race more than 400 years on.

Talking to yourself can help you control stressful emotions

July 26, 2017
The simple act of silently talking to yourself in the third person during stressful times may help you control emotions without any additional mental effort than what you would use for first-person self-talk – the way people ...

Do all people experience similar near-death-experiences?

July 26, 2017
No one really knows what happens when we die, but many people have stories to tell about what they experienced while being close to death. People who have had a near-death-experience usually report very rich and detailed ...

Risk for bipolar disorder associated with faster aging

July 26, 2017
New King's College London research suggests that people with a family history of bipolar disorder may 'age' more rapidly than those without a history of the disease.

Visual clues we use during walking and when we use them

July 25, 2017
(Medical Xpress)—A trio of researchers with the University of Texas and Rensselaer Polytechnic Institute has discovered which phase of visual information processing during human walking is used most to guide the feet accurately. ...

Toddlers begin learning rules of reading, writing at very early age, study finds

July 25, 2017
Even the proudest of parents may struggle to find some semblance of meaning behind the seemingly random mish-mash of letters that often emerge from a toddler's first scribbled and scrawled attempts at putting words on paper.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.