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CAT scan for diagnose of mental problems

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Posted by: Vieope

I have seen that CAT scans can help to identify mental disorders and personality disorders. Anyone have a list of what can be dicovered with a CAT scan or other physical exam?


Posted by: bandaidwoman

Not cat scans, there may be a potential for PET scans and MRI, but not Cat scans

http://www.mcmanweb.com/article-243.htm

For instance, MRI studies on people with ADHD do show differences in the amount of gray matter etc. from their non ADHD counterparts. I can pull that study if you need to reference it.


Posted by: Vieope

Quote:
Originally Posted by bandaidwoman
Not cat scans, there may be a potential for PET scans and MRI, but not Cat scans
What if the pet is a cat?

Anyway, I would appreciate if you could find the study on ADHD. Thanks


Posted by: bandaidwoman

Here you go!

Quote:



MRI Visualizes Anatomical Abnormalities in ADHD


Laurie Barclay, MD


Nov. 20, 2003 — Anatomical abnormalities associated with attention deficit–hyperactivity disorder (ADHD) can be visualized on high-resolution magnetic resonance imaging (MRI), according to the results of a study published in the Nov. 22 issue of The Lancet.

"Our morphometric procedures allow more precise localization of group differences than do the methods used in previous studies," lead author Elizabeth R. Sowell, PhD, from the University of California at Los Angeles, says in a news release. "Our results therefore suggest that the disturbances in prefrontal cortices are localized to more inferior aspects of prefrontal regions than was previously appreciated. Our findings also indicate that prefrontal abnormalities are represented bilaterally, by contrast to the predominantly right-sided findings that were emphasized in other reports."

Of 27 children and adolescents with ADHD evaluated in this study, 11 were girls and 16 were boys. Compared with 46 controls without ADHD who were matched for age and sex, those with ADHD had reduced regional brain size localized predominantly to small areas of the dorsal prefrontal cortices, as well as in bilateral anterior temporal areas. The ADHD group also had significant increases in the gray matter in large regions of the posterior temporal and inferior parietal cortices.

"The findings are not only in brain regions controlling attention, but also in regions that subserve impulse control," says coauthor Bradley Peterson, MD, from Columbia University and the New York State Psychiatric Institute in New York City. "Disordered impulse control is often the most clinically debilitating symptom in children with ADHD."

Although measures of the severity of ADHD symptom subtypes generally did not correlate significantly with these morphological measures, gray matter in the occipital lobe was inversely correlated with measures of inattention.

Study limitations include small sample size precluding subtyping by anatomical abnormalities and possible confounding by stimulant drugs, which were used by 15 of the 27 patients.

"These findings may help us understand the sites of action of the medications used to treat ADHD, particularly stimulant medications," Dr. Peterson says. "In conjunction with other imaging techniques, the findings may help us to develop new therapeutic agents given our knowledge of the cellular and neurochemical make-up of brain regions where we detected the greatest abnormalities."

The National Institutes of Mental Health and the Suzanne Crosby Murphy Endowment at Columbia University helped support this study. The authors report no financial conflicts of interest.

Lancet. 2003;362:1699-1707

Reviewed by Gary D. Vogin, MD
Small study but nevertheless,compelling.


Posted by: Vieope

Thanks but reading from those two pages I guess it is still in experimental phase. Not actually a normal thing a doctor would use to diagnose a mental condition. It is not a good thing to know that someone still needs to trust the subjective diagnose of a doctor.


Posted by: bandaidwoman

Quote:
Originally Posted by Vieope
Thanks but reading from those two pages I guess it is still in experimental phase. Not actually a normal thing a doctor would use to diagnose a mental condition. It is not a good thing to know that someone still needs to trust the subjective diagnose of a doctor.


The field of psychiatry and psycology do not hold the monoply on the fact that a diagnosis requires a certain degree of guesswork in addition to analyitical skills using the tools of science and deductive reasoning and a certain amount of detective work.

For instance, a man comes in paralyzed on the left side and has a facial droop. Many times the head scan and an MRI done within the first 24 hours of a stroke will be absolutely, stone cold normal! Do we rely on these "objective" diagnostic tools to make our diagnosis of a stroke or go by the physical exam finding that shows abnormal reflexes and a history suggestive of a stroke? I've also seen CAT scans, not uncommonly, miss appendicitis and the surgeon had to base his decision to operate on his clinical diagnosis (and sometimes gut instinct) despite a normal CAT scan!


Also,these tools can suggest something is there when it's not.

There was a woman who had an MRA (magnetic resonance angiogram using MRI technology) that showed a severe blockage in one of the arteries to her neck. She underwent an invasive angiogram using contrast dye just before her surgery. In the meantime, the angiogram showed utterly no blockages and we were lucky she did not suffer a stroke and kidney failure while getting the angiogram (a small but not uncommon risk associated with getting angiograms with dye)

In other words, you don't want doctors or any clinicians relying solely on these objective "diagnostic tests" to make their diagnosis, because many times they cannot stand on their own! This is where assessing the whole clinical picture comes in,.....and yes.... it does depend in part of subjective interpretation of the scientific data in front of you. (wether its trying to diagnose schizophrenia or appendicitis).

That's why medicine is called an art as well as a science.


Posted by: Vieope

Quote:
Originally Posted by bandaidwoman
That's why medicine is called an art as well as a science.
That is a good point. But with so many mental conditions and they all looking like the same, at least for the inexperienced eye, it would be nice to have some accurate method to help psychiatrists.

I don´t know if you studied that field but the definitions on the DSM-IV seem almost the same to me.


Posted by: bandaidwoman

Quote:
Originally Posted by Vieope
That is a good point. But with so many mental conditions and they all looking like the same, at least for the inexperienced eye, it would be nice to have some accurate method to help psychiatrists.

I don´t know if you studied that field but the definitions on the DSM-IV seem almost the same to me.
Psychiatry is probably one of the most diagnostically challenging specialties of medicine because of the lack of good objective diagnostic tools.

I've always felt the field does not get the respect they deserve (unlike cardiothoracic surgeons, neurosurgeons etc.etc.) from both the lay people and fellow doctors alike.

But remember, psychiatry is a relatively new field in medicine (It was only less than century ago we were preforming lobotomies on "aggressive women" or gay men and women).

They do have powerful diagnostic tools in the form of a person's response to the the pharmacopeia of medicines that affect the neurotransmitters, and this also aids in their diagnosis.

For example:
A 12 year old who is disorganized in thinking and inattentive in school, fidgety, has poor school performance and very hyperactive can be in hypomanic bipolar state or has ADHD. (The two can mimic each other in the younger population.) The one with ADHD will dramatically improve with stimulants such as Ritalin, the bipolar manic person will get dramatically worse. (Of course this can be symptoms of being traumatized from parental abuse at home, speed and amphetamine abuse etc. but I'm trying to be simple)

You bring up a good point. Psychiatry,like all other fields in medicine involves pattern recognition (taking many many symptoms, signs and variables ) and putting them together to give a coherent diagnosis and sometimes a subtle difference in presentation alters dramatically the correct diagnosis. But that's where years of training and practice and learning comes in. This constant battle and struggle to look at the pieces of information and bring it together into a diagnosis and plan of treatment ensues for the remainder of a practioner's life.


Posted by: Vieope

Quote:
Originally Posted by bandaidwoman
But remember, psychiatry is a relatively new field in medicine (It was only less than century ago we were preforming lobotomies on "aggressive women" or gay men and women).
Yeah, it is such a new field and with so much stigma around it that it seems just one more institution with ideas of how you are supposed to behave. That old argument that we use drugs to cure the symptoms and not the problems is another issue why I would not consider taking medicines, in another hand psychotheraphy doesn´t sound so appealing as well.

I blame it on the stress because OCD, ADHD, depression and other mental issues is just how the body responds to a certain environment. Big cities are not that healthy.


Posted by: maniclion

Quote:
Originally Posted by bandaidwoman
Psychiatry is probably one of the most diagnostically challenging specialties of medicine because of the lack of good objective diagnostic tools.
Right up there with being a vet, animals can't tell you where they hurt or how long they've felt that way.


Posted by: bandaidwoman

Quote:
Originally Posted by maniclion
Right up there with being a vet, animals can't tell you where they hurt or how long they've felt that way.

True, I think most people don't realize it is much harder getting into vet school than medical school. They are some smart people!


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CAT scan for diagnose of mental problems


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