Psychiatric Council Warns against
Unproven Brain Imaging Procedures

Stephen Barrett, M.D.

The American Psychiatric Association Council on Children, Adolescents and Famiies has warned against unproven uses of several types of brain imaging procedures. Its January 2005 report, which emphsizes concerns about single photon emission computed tomography (SPECT), concludes:

Although knowledge is increasing regarding specific pathways and specific brain areas involved in mental disease states, at present the use of brain imaging to study psychiatric disorders is still considered a research tool. Continued study of child and adolescent psychiatric disorders using a variety of brain imaging methods, as well as refinements in imaging techniques, may result in evidence supporting the utility of these tools for clinical work in the future. Imaging research cannot yet be used to diagnose psychiatric illness and may not be useful in clinical practice for a number of years. In the future, imaging techniques may be useful to examine medication effects and predict medication response.

Specifically, no published investigation in the field has determined that any structural or functional brain abnormality is specific to a single psychiatric disorder. Additionally, imaging studies examine groups of patients and groups of healthy controls; therefore, findings may not apply to all individuals with a given
disorder. Even when significant differences are identified between groups, there is a substantial overlap among individuals in both groups.

Particular caveats are indicated with regard to brain imaging involving radioactive nucleotides for children and adolescents because of children’s known greater sensitivity to radiation and risk of radiation induced-cancer. The long term risks of initial and repeated exposure to intravenous radio nucleotides are unknown.

We conclude that, at the present time, the available evidence does not support the use brain imaging for clinical diagnosis or treatment of psychiatric disorders in children and adolescents.

Additional Information

This page was posted on February14, 2007.

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