Abstract
Magnetic resonance imaging (MRI) is rarely used as an investigation in clinical psychiatric practice. The reasons for this are several, and include the cultural viewpoint of psychiatry as a psychosocial specialty as well as particular concerns about the experience of brain imaging amongst patients and clinicians. Where MRI is used it is to exclude neurological disorders in those presenting with mental illness. However the yield of such disorders through MRI screening not detected through other clinical examination in ‘typical’ presentations of mental illness is very low, and routine MRI is not currently recommended for those with mental illness without warning signs of neurological disorder. However functional imaging does have clinical potential, with the possibility for assisting both with diagnosis and treatment planning, and this potential will be discussed.
Highlights
Magnetic resonance imaging (MRI) is rarely used as an investigation in clinical psychiatric practice
FMRI TO PREDICT TREATMENT RESPONSE IN DEPRESSION Using these methods there are reliable patterns of abnormalities shown in the emotion processing network in depression, with underactivity in anterior cingulate, and overactivity of the amygdala in particular (Drevets et al, 1997)
MRI is rarely used in clinical psychiatric practice, with a lack of current evidence that it is cost effective in improving diagnosis
Summary
Magnetic resonance imaging (MRI) is rarely used as an investigation in clinical psychiatric practice The reasons for this are several, and include the cultural viewpoint of psychiatry as a psychosocial specialty as well as particular concerns about the experience of brain imaging amongst patients and clinicians. There is currently an arbitrary division of brain disorders into the specialties of psychiatry and neurology, with different terminologies for the same phenomena, and different clinical practices This has been to the detriment of patients on both sides of the divide. The use of MRI and perfusion hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT) in the early differential diagnosis of dementia sub-types should be part of routine care In these cases clinicians and patients should expect imaging to be part of the normal assessment protocol. The implication is that illness is predetermined by brain structure and function, and that there is little control the individual can have over their recovery
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