In a review article for this month’s American Journal of Psychiatry, Daniel Weinberger and Eugenia Radulescu from John Hopkins University push back against the overreliance on MRI scans in recent psychiatric studies. While acknowledging that they both have contributed to this type of research in the past, the authors warn that “findings” from these studies “pose a serious risk of misinforming our colleagues and our patients.”
The search for brain structures or “abnormalities” underlying mental health problems began in the early 1900s, with scientists carefully examining the brains of deceased patients. The authors point out that many of these early studies yielded findings, “but none withstood the test of time and more critical analysis of the subject.” By the end of the century, however, advances in technology made is possible for researchers to attempt to study the brain in living patients, setting off a “renaissance of neuroanatomical investigations.”
“It is almost impossible to pick up a current psychiatric journal and not see a study of anatomical measurement made on MRI scans comparing patients with a psychiatric diagnosis with healthy subjects,” they write.
The authors express concern that so many of these studies are claiming to discover biological differences in the brains of psychiatric patients that “it has become research lore that structural changes in the brain are characteristic of many psychiatric disorders and are likely clues to primary neurobiology.”
“These various findings are routinely referred to as ‘cortical thinning,’ ‘atrophy,’ ‘tissue loss,’ or worse, and they are assumed to be insights into the underlying nature of these conditions.”
These findings and assumptions are not supported by the science, according to the authors, as any “differences” found in the brain scans may simply be artifacts of a secondary symptom with no relation at all to the patient’s mental health. In addition, data from MRI studies can routinely be compromised by several confounders, including head motion and breathing, smoking, body weight, metabolic variations, medical comorbidities, psychoactive drugs, alcohol use, and even mental states.
“The overarching purpose of this cautionary note is to encourage a discussion about a widely and tacitly recognized, though mostly ignored, “inconvenient” truth: that conventional MRI does not allow us to make firm inferences about the primary biology of mental disorders and that we need to acknowledge this as a starting point in realizing the full value of MRI studies in psychiatry.”
Weinberger, D. R., & Radulescu, E. (2015). Finding the elusive psychiatric “lesion” with 21st-century neuroanatomy: a note of caution. American Journal of Psychiatry, appi-ajp. (Abstract)
Finally, a couple of psychiatrists who are willing to state the truth. This kind of psychiatrist I can respect.
But then of course this won’t matter because the rest of them will go on spouting the lies and business will be as usual.
The psychiatrists are lying .. But without going more into it, this particular article is limited. Brain scans of the right type such as electron spin resonance have already led to tracking of emotions and thought processes that allow auto diagnosis. Also when it comes to brain injuries sustained over ones lifetime that will cause mental disturbances and breakdown of function. Sometimes mental states do cause changes in brain layout.
The psychiatrists and researchers are generally lying and releasing fake studies to cover up that researchers and military agencies have already fully cracked the brain but none of that information is being made public. We can tell when a patient is hallucinationg or depressed, hungry, or constipated using brain scans in the classified military realm. We can pull out passwords and information, dreams, places you have been, images and sound from the brain.
But the articles hardly cover it. And no one is publically discussing it because of NDAs and classification.
As a joke, I could say the psychiatrists don’t want neurologists to take over prescribing drugs/medicines.
Different source say different things about the brain in mental illness.
As the business of psychiatry is prescribing medications/drugs for the perceived mental illness, prescriptions that add up to billions of dollars, the facts behind the prescribing will be manipulated. Drugs sales here http://psychcentral.com/lib/top-25-psychiatric-medication-prescriptions-for-2013/
Are you functional or non-functional?
Well, Tom Insell will be mortified. This is part of his whole new thing isn’t it? Sadly they still won’t accept that the brain damage they cause might be seen on scans as well? But then who’s looking? And I’ve told my family that if I exhibit any unusual behaviours they are to take me to a neurologist, NOT a psychiatrist. If I have a brain condition I want the people who actually KNOW about the brain to check it out. And if they can’t find anything, I want to go to a commune where there are lots of hugs.
“I want to go to a commune where there are lots of hugs.” No doubt, hugs will cure more ills than psychiatric drugs ever will.
But the neurologists prescribe the drugs, too. My prescribing “psychiatrist,” was a neurologist. And, they don’t KNOW much either, except how to create anticholinergic toxidrome in several ways.
And I had thought it was known that the brain scans were scams a long time ago, is this actually news?
No need to assign ill intent to the field of psychiatry in regard to brain scan studies. The sorts of research errors they likely are making are actually common throughout various fields. Lack of preregistered studies / publication bias, lack of control of confounding variables, mistaking correlation for causation, various forms of statistical fudging—mostly these things can be explained by sloppiness, the academic publish-or-perish mentality, and the genuine difficulty of performing quality research that leads to robust causal conclusions.
I’m not saying there aren’t bad actors. And yes, the incentive structure for researchers is largely messed up, rewarding quantity over quality. But I think mostly it’s genuine mistakes and lack of understanding that lead to these sorts of problems, and not just in psychiatry.
I will once again recommend PubPeer and RetractionWatch as places to get insight into the kinds of problems afflicting scientific research today. Deliberate fraud exists, but so do many other problems.
I do agree, it is the entire medical field that is now suffering from credibility problems. No doubt, largely due to the pharmaceutical industries’ across the board, greed inspired, fraudulent research, resulting in what appears to be largely a failure of an “evidence based medicine” system. Medicine was historically known as an “art,” for good reason.
But, when the entire medical field espouses belief in made up “mental illnesses,” which have no scientific validity or reliability, for reasons of greed. Just like the medical community in pre-WWII Nazi Germany did. Well, just how credible can a mainstream medical community be, that is not wise enough to learn from the medical atrocities of WWII?
And just how long will it take for today’s mainstream medical community to stop espousing belief in today’s scientifically invalid and unreliable, made up DSM disorders? And stop killing so many people with the psych drugs?
Personally, I think we need to take the scientifically unproven disorders out of the medical industry’s scope of control. Obviously, Germany’s medical community was not ethically capable of controlling such, and neither is today’s US medical community. And likely we need to massively rethink today’s seeming failure of an “evidence based medicine” system. And the medical community should realize that medicine is still just an “art,” which requires patience, humility, and a true desire to “first and foremost, do no harm.”
Plus, “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” The way our current medical system is set up, does not allow enough time for doctors to garner such insight. Which has resulted in an appalling number of unneeded deaths by our mainstream medical community.
Medicine for profit does not work.
It’s rather obvious that “research” is biased and off base because of the funding mechanisms in place. Insel started this BS and allocated tons of funding. It’s the “In” thing for now and when the tides change again, as they will because of the funding, we will be on to our next one note pony and drawing conclusions about what a selected handful wish to believe.