On a more objective test for ADD/ADHD using brain imaging

Nano-Passion

There has been quite a few studies on the difference in the neuralanatomy pertaining to ADHD/ADD patients. Can we use this for a more objective test for ADD/ADHD on patients?

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Am.%20J.%20Psychiatry[ta]%20AND%20168[vol]%20AND%201154[page]&doptcmdl=Abstract

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=J.%20Child%20Psychol.%20Psychiatry[ta]%20AND%2047[vol]%20AND%201051[page]&doptcmdl=Abstract

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=J.%20Child%20Psychol.%20Psychiatry[ta]%20AND%2047[vol]%20AND%201051[page]&doptcmdl=Abstract

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Am.%20J.%20Psychiatry[ta]%20AND%20168[vol]%20AND%201154[page]&doptcmdl=Abstract

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Arch.%20Gen.%20Psychiatry[ta]%20AND%2068[vol]%20AND%201122[page]&doptcmdl=Abstract

www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Neuropsychopharmacology[ta] AND 35[vol] AND 278[page]&doptcmdl=Abstract

zoobyshoe

The subjects in these studies must have been diagnosed with the current methods. For these studies to mean anything that method of diagnosis must have been assumed to be reliable. Diagnosis by brain scan can only affirm the assumptions that have already been made without the brain scans.

Are you thinking a brain scan would settle the issue in a case where someone questions a specific diagnosis of ADD/ADHD? It might cast doubt, I'm sure. If it's taken as definitive, though, it would mostly increase red tape: government assistance agencies and insurance companies would start demanding the "objective" brain scan for proof of the condition.

Nano-Passion

I'm thinking if we can use it to diagnose ADD/ADHD in patients instead of the questionares that are used (not always).

For the underlined part - Which would also be too expensive for the insurance companies, hmm.

SW VandeCarr

There are statistical tests that can compare patients with and without positive findings on standard testing and with or without positive neuro-anatomical findings. It's essentially a 2x2 contingency table. Whatever has been the standard instrument for diagnosing or not diagnosing ADD/ADHD in the case and control populations should be used.

Nano-Passion

I just had my ADD screening test today, it was just a questionnaire essentially. Why do they still use that method? It strikes me a bit odd because it seems anyone can fake it (not that I was). Why don't more places use a more objective test like the one that you have mentioned.

SW VandeCarr

Whatever test you may choose can be compared to the neuroanatomical findings this way, That's all I can say about this. You could have test that correlates with the neuroanatomical finding but doesn't correlate with the current clinical picture of what ADD/ADHD is. I'm not a psychiatrist so I can't really speculate on that. All I can say is if you think you have a reliable test and believe that there is a correlation with a neuroanatomical finding you can test that hypothesis in a rigorous way assuming your classification scheme is well defined.

Nano-Passion

I think it is a reliable test, no doubt about that actually. However what I am worried about is that crafty students can fake the test to take the prescription.

SW VandeCarr

All I can say is, if that's the case, you don't have a reliable test. There are ways to design tests to catch that sort of thing. Again, it's not my field, but psychiatrists and their test designers deal with this or similar kinds of problems all the time.

Nano-Passion

Ya i think the mechanism is that they throw in irrelevant questions to see if people try to fake the test, other than that people can fake it if they are clever and have done their research. I've seen the test myself today.