Ellen Harrell

Mr. Conway

Diverse Learners

22 March 2018

Annotated Bibliography

Abrams, L. (1 May 2013). Study: Most people diagnosed with depression do not actually meet

criteria. The Atlantic. Retrieved from https://www.theatlantic.com/health/archive

/2013/05/study-most-people-diagnosed-with-depression-do-not-actually-meet-

criteria/275

436/

This article reviews a study that showed that most people with a depression diagnosis do
not have depression when they are reevaluated. It also provides statistics, including the
percentage of people who had used antidepressants in this study to manage their symptoms. The
article also reviews what demographics were more likely to have correct diagnoses. The article
implies that the diagnosis process is rather subjective. It reviews the diagnosis process as being
hard to walk away with an answer, but rather an opinion or guess. This article may be useful
when discussing the issues in the diagnosis process. It may also help to reveal that the diagnosis
process is subjective. This article may also provide more incentive for imaging to be used, as
imaging provides a more specific, tangible piece of evidence for a diagnosis.

Amen, D. (16 Oct. 2013). The most important lesson from 83,000 brain scans. Retrieved

from https://www.youtube.com/watch?v=esPRsT-lmw8&t=1s

This TED Talk is by the celebrity doctor considered to be the pioneer in SPECT imaging,
Dr. Daniel Amen. He advocates using SPECT scan as a tool to diagnose mental illness in order
to better guide the treatment of patients. Amen reviews how SPECT imaging shows the different
levels of activity in the brain, and what activity looks like in different mental disorders. He goes
over how brain activity shows you that not all mental illness will be the same type of mental
illness; for example, there are many types of depression, and in one type you could have an over-
activated brain while in the other type you might have an under-activated brain. He stresses that
Psychiatry is the only field that doesn’t look at the organ being directly treated. He also examines
some of the outcomes of his studies, such as showing that criminals brains can be rehabilitated.
Carey, B. (18 Oct. 2005). Can brain scans see depression? The New York Times.

Retrieved from http://www.nytimes.com/2005/10/18/health/psychology/can-

Brain-scans-see-depression.html

This source is a good overview as to why psychiatrists are not diagnosing mental illness
currently using imaging. It goes over how we have not accumulated enough research to use
imaging as a diagnostic tool yet. The source includes a brief overview of how imaging is mostly
being used for research purposes currently, and scanning is currently valuable in Psychiatry for
diagnosis of tumors, head trauma, and seizure activity. It also goes over the criticism that brains
vary from person to person, and you cannot look at one person’s brain expecting the exact same
structure as the last person. Carey reviews how findings from brain imaging studies sometimes
contradict each other, making the implications of research all the more complicated. This source
will be useful for describing the reasons why brain imaging has not been used as a diagnostic
tool, and what the barriers standing in the way are.

Chen-hua, C., Ridler, K., Suckling, J., Williams, S., H. Fu, C. H. Y., Merlo-Pich, E. & Bullmore,

E. Brain Imaging Correlates of Depressive Symptom Severity and Predictors of Symptom

Improvement After Antidepressant Treatment. Biological Psychiatry 62(5) 407-414.

Retrieved from http://www.biologicalpsychiatryjournal.com/article/S0006-3223

(06)01191-7/fulltext

This study discusses how antidepressants change brain matter. It discusses how SSRIs
result in brain changes that result in symptom changes. The study notes that it would be useful to
psychiatrists and others that work to treat mental illness to be able to predict the response that
people have to antidepressant drugs. The study observed 17 different patients with major
depressive disorder. These people had their brain structure and function measured before they
were treated with fluoxetine, or Prozac. The subjects took 20 milligrams a day. Those running
the study used the Hamilton Rating Scale for Depression to determine how much the symptoms
changed, along with their severity. This study found that when grey matter volume in the brain
changed as a result of taking 20 mg of fluoxetine every day, their symptoms changed
significantly. This study is useful because it has indicated that the anterior cingulate cortex could
predict the response to antidepressant treatments. The anterior cingulate cortex can indicate how
well an individual will respond to treatment by its baseline or pre-treatment activity. This study
is useful in regards to brain imaging and treatment because it shows the prospect of one brain
region to indicate how to lessen the severity of depression symptoms by looking at MRI and
fMRI data.

Drysdale, A. T., Grosenick, L., Downar, J., Dunlop, K., Mansouri, F., Meng, Y., … Liston, C.
 (2017). Erratum: Resting-state connectivity biomarkers define neurophysiological

subtypes of depression. Nat Med, 23(2): 264. doi: 10.1038/nm0217-264d.

This article goes over how depression is not a single disease. Rather, depression has four
different distinct types that have different biomarkers. These biomarkers are different pathways
in the limbic system as well as in the frontostriatal circuits. Each different form of depression is
marked by dysfunction in these two systems. Oftentimes, symptoms will overlap between the
multiple types, but each type responds differently to treatment. This study has found that a good
way to identify different types of depression is to identify a group of symptoms that occur
together in an individual, and then to test to see what biological structures match with the
clusters of symptoms. This study will be useful in reviewing the flaws in the mental illness
diagnosis process, the different subtypes of mental disorders, and the other perspectives in which
we can look at mental illness.

Fung, G., Deng, Y., Zhao, Q., Li., Z., Qu, M. Li, K., … Chan, R. C. (2015). Distinguishing

bipolar and major depressive disorders by brain structural morphometry: a pilot study.

BMC Psychiatry, 15(1) 298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/

articles/PMC4655080/

This study compares the brains of individuals with bipolar disorder to individuals with major
depressive disorders. The study shows that individuals with bipolar disorder have significantly
larger cortical surface area than those with major depressive disorder. The study used “vertex-
wise cortical based brain imaging techniques to examine cortical thickness and surface area.”
These two factors are both based off of genetics, which would shed light on the genetic factors
involved in bipolar disorder. The study also talks about the difficulty in differentiating these two
disorders for clinicians. Furthermore, the study reviews how people with bipolar disorder have
more “white matter abnormalities, grey matter volume reductions, and different aberrant
functional connectivity in the neural circuits responsible for emotional regulation…” This study
will be useful in discussing how neuroimaging can be specifically used to differentiate major
depressive disorder and bipolar disorder.

Keener, M. T. & Phillips, M. L. (2009). Neuroimaging in Bipolar Disorder: A critical review of

current findings. Curr Psychiatry Rep. 9(6) 512-520. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686113/

This study is useful in comparing unipolar depression and bipolar disorder. It shows how
neuroimaging has distinguished the two disorders. It also discusses how neuroimaging studies
allow “endophenotypic markers” to be found, and these markers can help distinguish bipolar
disorder from depression. It discusses how finding these markers can distinguish who will
develop bipolar disorder, allowing for early intervention. The study also reviews the direction
that neuroimaging is taking in regards to bipolar disorder, alongside how medication affects
people with bipolar disorder. The study also suggests that bipolar individuals who use certain
medication have brains that more closely resemble those of healthy individuals than bipolar
patients that do not medicate.

Sankar, A., Zhang, T., Gaonkar, B., Doshi, J., Erus, G., Costafreda, S., . . . Fu, C. (2016).

Diagnostic potential of structural neuroimaging for depression from a multi-ethnic

community sample. BJPsych Open, 2(4), 247-254. doi:10.1192/bjpo.bp.115.002493

This study is useful because it shows how neuroimaging can be used across different
ethnic groups. The study looked at different ethnic populations, including Asians, Africans, and
Caucasians. It looked at 23 people with major depressive disorder who were in “an acute
depressive episode” in comparison to 20 healthy individuals. The study looked at the white and
grey matter in these populations. The study found that “structural neuroanatomy combining
white and grey matter distinguished patients from controls at the highest accuracy of 81%, with
the most stable pattern being at around 70%.” The study found different frontal, parietal,
occipital, and cerebellar structures all were biomarkers that “contributed towards diagnostic
classification.”

Sprooten E, Rasgon A, Goodman M, Carlin A, Leibu E, Lee WH, & Frangou S (2017).

Addressing reverse inference in psychiatric neuroimaging: Meta-analyses of task-related

brain activation in common mental disorders. Human Brain Mapping PMID: 28067006

This study is useful because it analyzes the differences in brain imaging among five
mental illnesses: schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders,
and obsessive compulsive disorder. This study is useful because it recognizes both the strengths
and weaknesses of using imaging. One one hand, imaging reveals that these disorders are all
concentrated in the limbic system, which is problematic considering these disorders all need to
be treated differently. On the other hand, the study reveals that the cerebral cortex is less related
to the mental illnesses at hand. This study also acknowledges that getting an fMRI may make a
patient more anxious, activating their limbic system. This would not be related to a mental
disorder, but rather a natural reaction to a frightening stimulus.

Singh, T., & Rajput, M. (2006). Misdiagnosis of Bipolar Disorder. Psychiatry (Edgemont),

3(10),
 57-63. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945875/

This article reviews the misdiagnosis in bipolar disorder. It discusses how many patients
are misdiagnosed with bipolar disorder initially. It also discusses the duration of time it takes for
individuals with bipolar disorder to get an accurate diagnosis. The study also reviews how a large
proportion of people with bipolar disorder are initially diagnosed with unipolar depression
instead. The study reviews the diagnosis criteria by the DSM-IV (which is no longer used, but is
still interesting historically). It discusses how the DSM-IV criteria was overly restrictive in
diagnosing bipolar disorder. This information is useful in discussing how mental illness is and
was misdiagnosed, and this information can be compared with current information about
diagnosing bipolar disorder.