No reliable anatomical or functional alterations have been confirmed in psychiatric neuroimaging; however it can become reliable with translational impact on clinical practice when considering crucial methodological issues.
Article Why are psychiatric imaging methods clinically unreliable? C...
There is an example of this question. A recent study showed that personal characteristic data can be used to perform better diagnosis than fMRI data.
ADHD-200 Global Competition: diagnosing ADHD using personal characteristic data can outperform resting state fMRI measurements
Brown MRG, Sidhu GS, Greiner R, Asgarian N, Bastani M, Silverstone PH, Greenshaw AJ and Dursun SM (2012) ADHD-200 Global Competition: diagnosing ADHD using personal characteristic data can outperform resting state fMRI measurements. Front. Syst. Neurosci. 6:69. doi: 10.3389/fnsys.2012.00069
http://www.frontiersin.org/Systems_Neuroscience/10.3389/fnsys.2012.00069/abstract
More reliable than one would think! See eg. Plichta, M. M., A. J. Schwarz, O. Grimm, K. Morgen, D. Mier, L. Haddad, A. B. Gerdes, et al. "Test-Retest Reliability of Evoked Bold Signals from a Cognitive-Emotive Fmri Test Battery." [In eng]. Neuroimage 60, no. 3 (Apr 15 2012): 1746-58.
Best, Andreas Meyer-Lindenberg
What is still not yet quite reliable is our (psychiatric) clinical methods of diagnose... proper clinical diagnosis is performed with phenomenology. Thus, measuring with MRI that which we do not know precisely what it is, can only produce non-replicable results and misleading conclusions. Take for example what is named "mood disorders", how many patients we see that do not fit exactly in one criteria or another? For instance, depression + anxiety or early days of bipolar presentation?
Research in Schizophrenia is another very good example. Symptoms and categories are often mixed within the same study group.
Maybe time will show us that the imaging tools can e more useful in certain cases, but then I pose a question: Will it be more reliable than a clinical interview? It is part of our clinical work to interact with the patients, and imaging tools may prove to be quite poor to grasp the most important pathological aspects quicker or more efficiently than our own tools...
Sorry no answer, only more questions..
The emerging field (and the term) of 'psychoradiology' suggests that we are getting closer to validating the use of MRI in psychiatry, particularly for diagnostic evaluation and treatment outcomes. The early issues related to inconsistent reported results but this was mainly due to widely differing methodologies. With more epidemiological studies being published, differences between reports are becoming more consistent. This will (hopefully) lead to greater psychiatric neuroimaging reliability. The other major issue lies in the diagnostic criteria of different psychiatric illness. If we keep relying heavily on DSM then this problem will persist. That is, a patient diagnosed with condition A may be diagnosed with condition B by someone else. So, what is needed is better, more valid and consistent diagnostic tools. However, they also need to be accessible, quick and cheap. They also need to be administered in exactly the same way by different academics and clinicians.
The problem lays in the absence of understanding etiology of symptoms related to mental illness. History demonstrates researchers propensity to ascribe structural attributes to a psychiatric medication while failing to consider adverse drug effects for medications taken for that symptom cluster. Take for example the research on enlarged ventricles inaccurately associated with schizophrenia and cerebral shrinkage inaccurately associated with ADHD/ADD.
It will be critical to have a large null filled with completely treatment naive participants for creating accurate diagnostic strategies using "psychoradiology."
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