Imaging may unlock new mental illness diagnosis options

October 11, 2013 by Adela Talbot, University of Western Ontario

(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

People with prosthetic arms less affected by common illusion

January 22, 2018
People with prosthetic arms or hands do not experience the "size-weight illusion" as strongly as other people, new research shows.

Intensive behavior therapy no better than conventional support in treating teenagers with antisocial behavior

January 19, 2018
Research led by UCL has found that intensive and costly multisystemic therapy is no better than conventional therapy in treating teenagers with moderate to severe antisocial behaviour.

Babies' babbling betters brains, language

January 18, 2018
Babies are adept at getting what they need - including an education. New research shows that babies organize mothers' verbal responses, which promotes more effective language instruction, and infant babbling is the key.

Inherited IQ can increase in early childhood

January 18, 2018
When it comes to intelligence, environment and education matter – more than we think.

College branding makes beer more salient to underage students

January 18, 2018
In recent years, major beer companies have tried to capitalize on the salience of students' university affiliations, unveiling marketing campaigns and products—such as "fan cans," store displays, and billboard ads—that ...

Modulating molecules: Study shows oxytocin helps the brain to modulate social signals

January 17, 2018
Between sights, sounds, smells and other senses, the brain is flooded with stimuli on a moment-to-moment basis. How can it sort through the flood of information to decide what is important and what can be relegated to the ...

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.