8 ms·

It is not that hard to recognize symptoms of mental illness. You certainly don't need to be a psychiatrist or a clinical psychologist. You don't even need to be

by eavc 14y ago

It is not that hard to recognize symptoms of mental illness. You certainly don't need to be a psychiatrist or a clinical psychologist. You don't even need to be a LCSW or a LPC. It would be, at most, a single course in an undergraduate or a graduate program. It could probably be rolled in to existing curricula just as a chapter or an exam as a component of a related class. We're not talking about diagnosis, just recognition of symptoms to the point where a referral can be made.

theatraine 14y ago
An interesting study highlighting some of the problems with diagnosis of schizophrenia was the Rosenhan experiment (http://en.wikipedia.org/wiki/Rosenhan_experiment http://en.wikipedia.org/wiki/Rosenhan_experiment) essentially it showed that doctors working in mental hospitals were unable to reliably tell the difference between those with schizophrenia, and those without it who reported a single hallucination. Albeit, the study is now close to 40 years old, and the diagnosis techniques have been improved, with for example, further editions of the DSM, major problems still exist. In my Master's thesis I created an algorithm to diagnose schizophrenia from EEG recordings. It's obviously very preliminary research, but it would be amazing to see computers revolutionizing the way that we do neurological diagnoses. My thesis is here for those interested: http://www.adriangreen.ca/Green_Adrian_CA_201211_MASc_thesis.pdf http://www.adriangreen.ca/Green_Adrian_CA_201211_MASc_thesis..., and hopefully soon to be condensed and published as a paper.
- vacri 14y ago
  Thanks for your article - a couple of questions. My background is that in the dim dark past I studied neuropsych and then worked as an EEG tech (mostly epilepsy screening with infrequent psych patients) for 4 years (2000-04) before going to work for the company that makes Synamps 2 :) Now, I've only skimmed your method and results as I'm a bit flu-ridden and hence vague, but a couple of things popped out. The first is that you stated there was no control for medication. In our experience doing EEGs on folks on certain psych drugs, there was usually an increase in higher band activity (more beta, much less slow wave) - these drugs would create an unusual but not clinically abnormal EEG. It was rare to see such an EEG in someone not on those drugs. The second is that for doing mathematical analysis on the EEG, I've had it trained out of me that resting EEG is okay to use. Some task, any task, no matter how easy, gives a more reliable baseline - since the EEG is quite dependent on arousal state, without a basic task, you don't have much control over whether the person is sitting there thinking about having a nap or highly alert and fretting over some unrelated item. For epilepsy you want them drowsy and nearly asleep as that lowers the bar for spike-and-wave activity, but unless a similar thing happens in schizophrenia and slowing, I'd think that doing a task would be superior to resting EEG. I wonder if accounting for these issues might increase your hit rate? Like I said, I only skimmed the method and results, so I may have missed something that makes these points less relevant. As an aside, the epileptic EEG sample looks really quaint and old-fashioned, since it has the curved needle-on-paper distortion. It doesn't need to be updated, it just looks like Ye Olde EEG to my eyes... :)
  - theatraine 14y ago
    The no control for medication is primarily based on the conclusions of Boutros 2008, a summary of spectral abnormality studies of schizophrenia. I reproduced a table from the paper in the appendix. What type of psych drugs were you working with? As an aside drugs used to treat schizophrenia have especially nasty side-effects, such as weight-gain, reduction of white blood cells, and--ironically--some of the "negative" symptoms of schizophrenia when given to healthy people. In fact the Soviets used to use antipsychotics to torture political prisoners. I concur that active EEG could lead to a much more accurate diagnosis, however we had access to quite a bit more resting data, and it does make the math easier (stationarity for one). Standardization of other factors would also probably increase accuracy, but once again, I was limited by my data. Since I'm no longer in academia, I won't be continuing the research, but hopefully further studies address these questions in more detail.
    - vacri 14y ago
      Sorry, it's so long ago that I can't recall the drugs, only that as techs we had to report what was on the referral. We'd do our tech reports and the official report done by the neurologist would refer to the flat, beta-filled EEG as being 'normal for -foo-'. Part of me wants to say benzos, but I'm not sure if that's confabulation on my part. I understand the limitation of the data - it's particularly hard to get access to inpatients as subjects for new studies. Thanks again for sharing your thesis - sorry I can't converse a bit more intelligently about it at the moment. EDIT: looks like it is benzos: Some agents, particularly benzodiazepines and barbiturates, induce fast or beta (β) rhythms, and the EEG may be a useful pointer to drug intoxication when this is clinically unsuspected. from http://jnnp.bmj.com/content/76/suppl_2/ii8.full http://jnnp.bmj.com/content/76/suppl_2/ii8.full
- eavc 14y ago
  To be clear, I was talking about recognition of symptoms and referral to experts, not diagnosis. Diagnosis is a much trickier issue. Thanks for sharing your thesis and for the interesting read about schizophrenia diagnosis.

by eavc 14y ago

theatraine 14y ago

An interesting study highlighting some of the problems with diagnosis of schizophrenia was the Rosenhan experiment (http://en.wikipedia.org/wiki/Rosenhan_experiment http://en.wikipedia.org/wiki/Rosenhan_experiment) essentially it showed that doctors working in mental hospitals were unable to reliably tell the difference between those with schizophrenia, and those without it who reported a single hallucination. Albeit, the study is now close to 40 years old, and the diagnosis techniques have been improved, with for example, further editions of the DSM, major problems still exist. In my Master's thesis I created an algorithm to diagnose schizophrenia from EEG recordings. It's obviously very preliminary research, but it would be amazing to see computers revolutionizing the way that we do neurological diagnoses. My thesis is here for those interested: http://www.adriangreen.ca/Green_Adrian_CA_201211_MASc_thesis.pdf http://www.adriangreen.ca/Green_Adrian_CA_201211_MASc_thesis..., and hopefully soon to be condensed and published as a paper.

vacri 14y ago
Thanks for your article - a couple of questions. My background is that in the dim dark past I studied neuropsych and then worked as an EEG tech (mostly epilepsy screening with infrequent psych patients) for 4 years (2000-04) before going to work for the company that makes Synamps 2 :) Now, I've only skimmed your method and results as I'm a bit flu-ridden and hence vague, but a couple of things popped out. The first is that you stated there was no control for medication. In our experience doing EEGs on folks on certain psych drugs, there was usually an increase in higher band activity (more beta, much less slow wave) - these drugs would create an unusual but not clinically abnormal EEG. It was rare to see such an EEG in someone not on those drugs. The second is that for doing mathematical analysis on the EEG, I've had it trained out of me that resting EEG is okay to use. Some task, any task, no matter how easy, gives a more reliable baseline - since the EEG is quite dependent on arousal state, without a basic task, you don't have much control over whether the person is sitting there thinking about having a nap or highly alert and fretting over some unrelated item. For epilepsy you want them drowsy and nearly asleep as that lowers the bar for spike-and-wave activity, but unless a similar thing happens in schizophrenia and slowing, I'd think that doing a task would be superior to resting EEG. I wonder if accounting for these issues might increase your hit rate? Like I said, I only skimmed the method and results, so I may have missed something that makes these points less relevant. As an aside, the epileptic EEG sample looks really quaint and old-fashioned, since it has the curved needle-on-paper distortion. It doesn't need to be updated, it just looks like Ye Olde EEG to my eyes... :)
- theatraine 14y ago
  The no control for medication is primarily based on the conclusions of Boutros 2008, a summary of spectral abnormality studies of schizophrenia. I reproduced a table from the paper in the appendix. What type of psych drugs were you working with? As an aside drugs used to treat schizophrenia have especially nasty side-effects, such as weight-gain, reduction of white blood cells, and--ironically--some of the "negative" symptoms of schizophrenia when given to healthy people. In fact the Soviets used to use antipsychotics to torture political prisoners. I concur that active EEG could lead to a much more accurate diagnosis, however we had access to quite a bit more resting data, and it does make the math easier (stationarity for one). Standardization of other factors would also probably increase accuracy, but once again, I was limited by my data. Since I'm no longer in academia, I won't be continuing the research, but hopefully further studies address these questions in more detail.
  - vacri 14y ago
    Sorry, it's so long ago that I can't recall the drugs, only that as techs we had to report what was on the referral. We'd do our tech reports and the official report done by the neurologist would refer to the flat, beta-filled EEG as being 'normal for -foo-'. Part of me wants to say benzos, but I'm not sure if that's confabulation on my part. I understand the limitation of the data - it's particularly hard to get access to inpatients as subjects for new studies. Thanks again for sharing your thesis - sorry I can't converse a bit more intelligently about it at the moment. EDIT: looks like it is benzos: Some agents, particularly benzodiazepines and barbiturates, induce fast or beta (β) rhythms, and the EEG may be a useful pointer to drug intoxication when this is clinically unsuspected. from http://jnnp.bmj.com/content/76/suppl_2/ii8.full http://jnnp.bmj.com/content/76/suppl_2/ii8.full
eavc 14y ago
To be clear, I was talking about recognition of symptoms and referral to experts, not diagnosis. Diagnosis is a much trickier issue. Thanks for sharing your thesis and for the interesting read about schizophrenia diagnosis.