Re: Ear can be used to diagnose certain mental illnesses

[Denis Donovan <dmdonvan@xxxxxxxxxxxxx>]

Title: Re: Ear can be used to diagnose certain mental illnesses

I would suggest that the "demonstration" Kevin Austen refers to below be taken with a hefty dose of lithium chloride and an even heftier dose of curiosity and skepticism.

First, note the first and last paragraphs in the associated story that was linked to the post. This is what Bush wanted to do: have the power to declare children mentally ill on a national scale. Notice the primary "diagnosis" targeted: "conduct disorder." George Orwell's Big Brother is alive, thriving and expanding daily in the English-speaking world.

The issues dealt with by this list are typically firmly grounded in the sensible world and are subject to the rigors of good scientific method. I happen to be interested in the developmental neuroscience of musical cognition and there are occasional shining nuggets to be found here. The world of the stories below is as different from what this list is typically about as apples are from washing machines.

My field, "psychiatry and the biobehavioral sciences" does not have presently, and has never had, a realistic phenomenology. However much my field my delight in viewing itself as "modern biological psychiatry" (Nancy Andreason's term in "The Broken Brain"), the field has only rebranded psychoanalytic and Piagetian concepts and models and changed the terminology. And, do note that a good decade after the so-called "Decade of the Brain," my medical specialty is still without a single valid and reliable diagnostic laboratory test. Try to imagine internal medicine in the same straits. To gain some perspective, just consider that as our diagnostic acumen has increased, everything -- from academic achievement to everyday behavior -- has gotten MUCH worse.

Just one example -- which should be particularly meaningful for Robert Zatorre since it took place in his back yard.

In 1991, the Canadian Province of Québec asked Jean-Jacques Breton, M.D., director of child psychiatry research at the Rivière-des-Prairies Hospital in Montréal, to conduct a provincial prevalence study of child psychiatric disorders. Breton and his colleagues from the University of Montréal did something practically unheard of in the field: they wondered if children would actually understand the questions on the assessment tool used to generate diagnoses-in this case, the Diagnostic Interview Schedule for Children (DISC-2), one of the most widely used structured interviews developed by David Shaffer, M.D. and his team at Columbia University. The results were stunning. Nine-, 10- and 11-year-old children understood only 38 percent of the questions on the DISC-2. Given its intensely embarrassing nature, I was astounded to see a version of Breton's findings in the New Research section of the 1993 annual meeting of American Academy of Child and Adolescent Psychiatry. When I asked him what his findings said about our field, Breton replied with a very sad smile, "That the child is of secondary importance in child psychiatry." How true, I thought to myself, but unfortunately your findings are likely  have zero impact on the education and mental health community.

Once again I was surprised to see the establishment take note of Breton's troubling data when, in July of 1995, the Journal of the American Academy of Child and Adolescent Psychiatry published a more polished version of the 1993 New Research version. True to form, in her discussion of the article, Mary Schwab-Stone, M.D. of the Yale Child Study Center wrote that "The endeavor to make the DISC good enough has taken longer than anyone wanted, as work began on it around 1980...." What Breton's data called into question in 1991-and remains unchallenged even today--is not the less-than-polished state of the Diagnostic Interview Schedule for Children but, rather, the field's very understanding of children. It is sobering, to say the least, that one of this country's premier academic child psychiatry divisions could be so out-of-touch with a realistic understanding of children that it never even noticed that its instrument was incomprehensible to the very children it was designed to assess.

That historical anecdote from our ever-increasing "scientific" sophistication is but a minuscule tip of an amazingly large and embarrassing iceberg.

http://www.theage.com.au/national/specialist-teams-will-target-youth-20091014-gxfy.html (101609)
Specialist teams will target youth
NICK MILLER
October 15, 2009

Four new youth mental health teams, due to be announced this month, will go into schools, youth centres and perhaps even shopping centres and railways stations to identify and help young people with early signs of mental illness.

The teams will be on the look out for drug and alcohol problems, depression, anxiety or eating disorders, as well as the early stages of more serious psychosis.

They are the first steps in the State Government's mental health strategy, released in March this year, which has a new focus on intervening early in mental illness.

Minister for Mental Health Lisa Neville said the teams would, for the first time, help young people who would be classified ''not sick enough'' in the existing system.

Three-quarters of mental illness begins before age 25, but due to a short supply of care only the sickest of young people can get access.

Paul Leyden, who runs child and adolescent mental health at Eastern Health and will set up one of the new teams, said it was a very exciting initiative. ''We know 3 per cent of the population have mental health issues but we are seeing less than 1 per cent,'' he said.

The teams will start work this year or early 2010 in eastern and western regions, followed by two more at Southern Health and Peninsula Health later next year.

The Government is providing $13.8 million to staff and resource the new teams, as well as $4.4 million for teams at primary schools to deal with early ''conduct disorder'', and $2.9 million to tackle autism.

> [A] ... research group
> here in Australia has just demonstrated how a probe inserted in the
> ear can be used to diagnose certain mental illnesses when the patient
> is moved incertain ways in a '3D' chair! They make use of the
> proximity between certain auditory functions and other mental
> functions in the brain.
>
> Regards,
> David
> Dr David
> Hirst
> Curriculum, Teaching
> and Learning Centre
> | La Trobe University
> | Bundoora 3086 Victoria  Australia |

http://www.theage.com.au/national/diagnosis-to-rock-the-world-of-mental-health-20091014-gxfx.html

--

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Denis M. Donovan, M.D., M.Ed., F.A.P.S.
Director, EOCT Institute

Medical Director, 1983 - 2006
The Children's Center for Developmental Psychiatry
St. Petersburg, Florida

Mail: P.O Box 47576
   St. Petersburg, FL 33743-7576
Phone:     727-641-8905
Email:      DenisDonovan@xxxxxxxxxxxxxxxxxx
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