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Different mental disorders cause same brain-matter loss, study finds [MedicalXpress.com]

 

In a study analyzing whole-brain images from nearly 16,000 people, researchers at the Stanford University School of Medicine identified a common pattern across a spectrum of psychiatric disorders that are widely perceived to be quite distinct.
The meta-analysis of 193 peer-reviewed papers, to be published Feb. 4 in JAMA Psychiatry, reports a loss of gray matter in three brain structures that, although physically separate, participate in a network associated with high-level functions including planning and decision-making.
The findings call into question a longstanding tendency to distinguish psychiatric disorders chiefly by their symptoms rather than their underlying brain pathology.
In any given year, nearly one in five Americans meets the criteria for a diagnosis of psychiatric illness. "The idea that these disorders share some common brain architecture and that some functions could be abnormal across so many of them is intriguing," said Thomas Insel, MD, director of the National Institute of Mental Health, who wasn't involved in the study but is familiar with its contents.

 

[For more go to http://medicalxpress.com/news/...ent-psychiatric.html]

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It is not one brain structure one diagnosis.  There are individuals with maltreatment histories who don't have psychopathology who have the same brain changes as another individual who does have psychopathology.  What may be the difference the protective (resilience) factors.  Changes in brain structures do not correlate with categorial DSM diagnoses. 

Early Life Stressor positive vs Early Life Strressor Negative (ELS+ vs ELS -) knowledge is important for studies.  In studies if one does not take into account having early life stress (i.e. child maltreatment) the biological studies to look for the etiology for example bipolar vs PTSD does not allow the researcher to find consistent results because the researchers are looking at different subject groups based on the presence or absence of early life stress.

Eco-biological-phenotypes ---- clinical history including a history of ELS+ vs ELS - is important.  DSM dx are based on phenotypes (symptoms expression - how one looks).  So many disparate DSM dx will have the same brain structural/network changes and there is no specific biomarker to diagnoses a DSM disorder for example bipolar since the DSM disorders themselves are based on phenotypic expression not on biological markers/imaging studies/ or network analyses of brain function.  DSM diagnoses aren't a good idea to use for treatment, as those with early life stress will respond differently to treatment than those without it but could still have the same DSM diagnosis - i.e. look the same but they are not genetically, epigenetically, or brain structurally.

ELS + patients have earlier symptoms, more severe and complex system manifestations, more likely to attempt suicide etc regardless of the DSM phenotypic diagnosis.
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