Posted by manowar on December 3, 2001, at 21:11:56
In reply to place of functional neuroimagining in psychiatry » manowar, posted by Elizabeth on November 30, 2001, at 16:58:20
> > I found out later that SPECT evaluations can be highly regarded evidence in insanity cases in the state of CA.
>
> [Insert California joke here]That's good...
Thanks Elizabeth, you make some very interesting and valid points. It's healthy to be skeptical about what "seems" to be pretty revolutionary. I just wanted to share what my opinion was (for what it's worth) along with others, because it seems that SPECT has gotten a bad rap here.
You're right, there is not any good "hard" data out there that SPECT is helpful in diagnosing and treating mental illness. The evidence that SPECT is useful is very speculative. But for that matter most of psychiatry along with most of everything that we talk about here on this site is speculation. Many times good science, research and proof woefully lag behind experience, common sense, discovery, and invention. My contention is that psychiatry is 90% speculation anyway. Even the monoamine theory of depression is still a theory, not a fact.
I think that one of the reasons that SPECT is not more widely accepted is because many people still believe that a person's "mental health" depends on his/her character. It's hard for most of us including myself to think that we are as "hard wired" as we are. The idea that someone is mentally ill- not because of a "psychological problem", but because there could be a physiological or functional malfunction is sometimes still be hard for me to accept. But at the same time, the thought was very liberating for me...
I have always thought that if I tried harder, went to the right psychoanalyst, or if I prayed enough, or whatever --I would get better. Having the scans done let me know once and for all (along with my doctors) that I had serious functional problems that needed to addressed aggressively with medication.
You know, the pdoc had to take a few minutes to prep me before I viewed my scans to get me ready for what I was about to see. He basically let me know that the image was a functional image not an anatomical image (I had some big holes of functioning all around my cortex). Paradoxically, when I saw the scans, it scared the hell out of me- but at the same time it relieved me.
It clarified that I had some real problems, and that I needed some real solutions. Since then, I have been much more compliant with treatment, and I have found a much better doctor. I'm also less hesitant about calling the doctor's office if I need to- rather than waiting for two more weeks for my appointment. I also believe that my doctor is a lot more sympathetic with me and aggressive with drug therapy than he would have been if I hadn't had the testing done.
People with chronic heart problems have SPECT, MRIs and EEG testing done all the time. What is so bad about having a SPECT done if a person has a chronic "mental health" problem?
In all, by having the scans done, I think that I'm much farther along in getting better than if I hadn't had them done.
Anyway, I'm not trying to argue here, I just thought that sharing my experience might be helpful.
--Tim
poster:manowar
thread:85484
URL: http://www.dr-bob.org/babble/20011202/msgs/85916.html