The need for clear diagnostic tools in the mental health field...

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    Apr 30, 2014 7:21 PM GMT
    My friend is earning their masters in psychology. I'm still amazed that science hasn't found a better diagnostic tool, rather than tests that are based on questions from a piece of paper to diagnose potential life threatening diseases such as major depression.

    Let's imagine trying to diagnose a diabetic and creating a treatment plan without knowing if someone is a type 1 (insulin-dependent) or type 2 (insulin-resistant) diabetic. It would be a disaster and the solutions would be filtered through a doctors opinion, not interesting results through a reliable diagnostic test.

    Having a clear diagnosis test for mental health professionals would:
    1) Separate patients that could benefit from cognitive therapy vs. patients that have an actual dysfunction in how the brain is processing emotions. Cognitive therapy will help in both accounts, but the latter would need medical intervention.
    2) The amount of manipulation and sexual abuse that occurs from mental health care providers often goes unreported; it's a disturbing corruption of power.
    3) Having a clear diagnostic test will allow patients to put their faith in science instead of a human. The answers need to come from an unbiased resource.
    4) It would decrease suicide rates related to pharmaceutical medicines, that aren't necessary for the patient. Ideally diagnostic tools will be able to calculate what neurotransmitters are being affected. Pharmaceutical companies can already judge if a medicine works primarily on dopamine, sertonin, norepherine, GABA etc.
    5) It would change so many people's lives, their work performance, and relationships for the better.

    Thoughts on this less than happy subject?


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    May 01, 2014 4:14 AM GMT
    At the moment, although some of them are -classified- as medical conditions, society at large really doesn't see them that way. Opinions vary, of course, but in my experience there is a very large chunk of society that sees depression and many other mental disorders as bullshit.

    I think that a more structued approach like what you're describing would help mental disorders become more easily accepted as actual medical conditions.

    This would be a very -good- thing.

    Of course, for this to happen, humans would have to truly understand the brain and all of it's complexities. Something that we aren't even close to accomplishing.
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    May 02, 2014 4:01 AM GMT
    TwisttheLeaf saidAt the moment, although some of them are -classified- as medical conditions, society at large really doesn't see them that way. Opinions vary, of course, but in my experience there is a very large chunk of society that sees depression and many other mental disorders as bullshit.

    I think that a more structued approach like what you're describing would help mental disorders become more easily accepted as actual medical conditions.

    This would be a very -good- thing.

    Of course, for this to happen, humans would have to truly understand the brain and all of it's complexities. Something that we aren't even close to accomplishing.



    I frustrates me to no end!

    In my dietician classes and when I interviewed and spent the day at a home for disabled individuals (they're called "clients") I learned about PKU.

    PKU basically means the individual can't digest phenylalanine. The client at the home had to consume less than 5 grams of protein for an entire day -- something that would be very hard to swallow for most RJs here.

    Phenylalanine being a precursor to tyrosine which aids in creating norepinephrine (this also aids in the balance of dopamine and serotonin) plays a role in mental health. If humans could see how similar the mind is to the body (diabetes) it would help progress the wellbeing of society. PKU was first related to mental retardation.

    It's not just mood disorders, BUT dementia, autism, insomnia etc. really should have better diagnostic tests and treatments. Mental wellbeing is kind of an untapped area in the medical field. Currently we just experiment with pills (which is great for the drug companies and helps a fair amount of patients) BUT it isn't the treatment people should expect in 2014.

    Dr. Lang on PKU:


    "PKU was initially described by Felling1 in 1934 when he associated mental retardation with elevated levels of phe in children. PKU is an autosomal recessive disorder that causes a deficiency of the hepatic enzyme phenylalanine hydroxylase (PAH) that is required to metabolize phe to the amino acid tyrosine."

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    May 02, 2014 4:04 AM GMT
    Thanks for posting Twistthelead icon_smile.gif
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    May 02, 2014 6:14 AM GMT
    This will happen eventually. The science hasn't got to the stage where this is possible yet. There's simply not enough known about what causes various different mental illnesses, nor have any reliable biomarkers been identified for use creating diagnostic tests.

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    May 05, 2014 12:45 AM GMT
    The thing about the DSM (the manual they use for mental health diagnosis) is that it's based on the American Psychological Association. I think it should be based more on Neuroscience, but unfortunately, that field needs more advancements since the brain is so complex. The DSM is a checklist, which can be helpful for professionals but also perhaps bias them.

    Also, I think a black and white diagnosis ("Yes/No") with mental health can be bad. Researchers of all kinds analyze their results based on statistics. That means they need a value point at which they know whether something is significant or not. The brain just doesn't go "I have/don't have this." It's more like a web or circuit of communications, and there are many ways in which that can be arranged and rearranged, which is what creates behavioral differences in people. Combine that with experiences and perceptions (that's where Psychology does help), and BAM, you don't know what to measure what should be happening in a person's brain, or more like to what degree.
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    May 05, 2014 7:26 PM GMT
    Yep. We may as well be using witch doctors and faith healers.

    On a tangential note, imagine what it's like for vets; they can't ask the dog or cat where it hurts or how they feel.

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    May 14, 2014 5:15 AM GMT
    While I somewhat agree with the OP about the need for a better diagnostic tool in the mental health field, I do not believe that any field in healthcare is without its diagnostic flaws. And it seems to me that the OP is just wanting to bash mental health professionals for behaviours that occur in many healthcare professions.

    Now, you said that your friend is doing a master's in psychology. I do not know what that specifically means i.e. I do not know what speciality of psychology your friend is pursuing. For instance, I am a clinical psychology student. Maybe you could have asked him to explain this to you rather than make a thread about it?

    "Having a clear diagnostic test will allow patients to put their faith in science instead of a human. The answers need to come from an unbiased resource." - The mental health professional uses scientific inventories (if they are trained in using it) to asses behaviours, adaptability, personality, intelligence, etc. I fail to see how this is any different than any other doctor giving a medical diagnosis or a mechanic finding something wrong with your car. It's all left to the clinical judgement of the person along with all the backing evidence to support a diagnosis.

    No (good) clinical psychologist (or psychiatrist) uses the DSM in isolation as a diagnostic measure for mental illness. Through psychological assessment (these tests meet good standards of scientific reliability and validity), a diagnosis can be made. The client is administered a standard test battery. For example, you mentioned major depression. The DSM, along with other tests such as the Beck Depression Inventory can be used to make this diagnosis. Scores on other tests on the battery will present with manifestations of the disorder as well which research has shown to correlate with the disorder the individual may be suspected to have.

    Through psychotherapy as well a diagnosis can be made, or at least an impression of it, which will prompt psychological assessment. It can work both ways, assessment can be used to evaluate what kinds of therapy will be best suited for a client. Again, this is all based on research.

    Without the knowledge of psychometrics and overall understanding of the field, I do not think you can fully appreciate the work that we do. Wouldn't you think that the tools used by mental health professionals, if so unscientific and biased, would have been done away with? Why has the field lasted so long? There is definitely something there working that you cannot grasp, that is indeed scientific, whether you choose to believe it or not.