[samhw]

Quite. Psychiatry loves to talk about brain scans and neuroanatomy, but until it dares to actually use them for diagnosis, I think it should be regarded as window dressing.

And you should always read these studies with a careful eye to whether the ADHD subjects are medicated. Often the studies literally measure the effect of the medication and nothing else. (It's a cruel irony for schizophrenics, who are put on antipsychotics that shrivel the cerebral cortex, only to find their shrivelled cerebral cortex brandished as evidence of their supposed dysfunction.)

Also, note that fMRI does not and cannot indicate structural abnormalities in the brain. It just measures current brain activity, as revealed by the flow of magnetically-charged oxygenated blood through the brain. It tells us these people's brains are currently behaving differently from control subjects' brains. Which, it seems to me, is stating the bleeding obvious.

[Jach]

It's a shame that every time someone (e.g. upthread) mentions how even just MRIs are very expensive, often as an excuse for not using such tools, I think of all the times I've heard that other places like India make them quite cheap. Well, it's just one part of a giant pile of problems.

Thanks for the reminder about schizophrenics. Even though I've known about the effect (and especially the effect with use of lithium, which is thankfully not so commonly used), I've sort of forgotten about it as a factor in my thinking about the recent struggles of someone in my personal life. It's probably not forgotten by those working in the system, and wouldn't surprise me if it contributes to the incentives of the system encouraging people to be shut-ins and never challenge anything.

[samhw]

Yeah, I am very troubled by it. I had a friend staying with me last year who I hadn't realised was schizophrenic (a hopelessly vague diagnosis but he undoubtedly had parted company with reality) and off his meds. It was horribly sad. He killed himself a few months later. My mum is a psychiatrist and insists that third-generation antipsychotics are not a 'chemical cosh', which I find doubtful, seeing as so many schizophrenics seem to consider them a worse prospect than unmedicated schizophrenia or death.

We're now giving these drugs to autistics, I gather, and low-dose olanzapine is even being trialled for kids with Asperger's. Compared with lobotomy I suppose it requires less cleaning up.

Since you mention India, I should add that India and other poor countries manage to treat schizophrenia with better remission rates than the UK and US: https://www.nature.com/articles/508S14a