Clinician's Digest - Page 7

Now a year later, the May 2010 AJP has printed a letter critical of Amen by psychiatrist Bryon Adinoff from the University of Texas Southwestern Medical Center and radiologist Michael Devous. Again challenging the scientific basis of Amen's work, they write that the Society of Nuclear Medicine offered him the opportunity to prove his claims that he could diagnose disorders through neuroimaging by submitting samples of his scans to a blind study. According to them, Amen ignored the offer. In a phone interview, however, Amen insisted that no such offer was ever made to him. Nor, he added, would he have accepted it because, he says, contrary to Adinoff and Devous's claim, he's never said that he can diagnose anyone solely on the basis of SPECT scans, which are only one component of a more comprehensive diagnostic procedure. He pointed out that Leuchter is financially involved with a rival brain-imaging company, and dismissed Devous as someone who's "not a physician." Accusing the three of "intellectual dishonesty," Amen pointed to more than 2,400 articles on his website, the majority in peer-reviewed journals, and his coauthoring of a chapter on functional imaging in the Comprehensive Textbook of Psychiatry. But while most of the articles discuss SPECT imaging, say his critics, almost none provide any empirical evidence of its efficacy in treatment.

The bitter debate reveals a common fault line between researchers and clinicians. From the research perspective, Amen's claims for the therapeutic use of SPECT scans are too far ahead of sufficient confirming empirical evidence, although he points to a 2001 study in the Journal of Nuclear Medicine that supports his contention. Adinoff and Devous insist that going public with their concerns isn't so much an attack on Amen as an attempt to protect the credibility of their field. If people have been "led astray by unsupported claims," they write, they'll be "less inclined to utilize scientifically proven approaches once these are shown in the peer-reviewed literature to be effective."

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Resources

Public Lives: Professional Psychology: Research and Practice 41, no. 2 (April 2010): 153-59. Team Approach: Journal of Systemic Therapies 28, no. 3 (Fall 2009): 89-102. Depression Self-Help: Behaviour Research and Therapy 48, no. 2 (February 2010): 152-57. Personality Disorders: Proposed changes can be viewed at www.dsm5.org. Depression and Diet: American Journal of Psychiatry 167, no. 3 (March 2010): 305-11; British Journal of Psychiatry 195, no. 5 (November 2009), 408-413. Brain-Scan Battles: American Journal of Psychiatry 166, no. 5 (May 2009): 625; and 167, no. 5 (May 2010): 598.

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