Coming of Age?: Neuroimaging Biomarkers in Youth

Mary L. Phillips, M.D.

Diagnosis of psychiatric illnesses is conventionally made by evaluating behavior and subjective report of abnormal experiences to group individuals into illness categories. These categories mask a great deal of heterogeneity, however, particularly in child-onset psychiatric illnesses such as bipolar disorder, an illness that remains notoriously difficult to differentiate from other psychiatric illnesses in youth. In the absence of objective biological markers—"biomarkers"—diagnostic accuracy for psychiatric illnesses therefore remains severely compromised. In this issue of the Journal, Brotman and colleagues (1) provide preliminary evidence that specific neuroimaging measures can help distinguish youth with bipolar disorder from youth with attention deficit hyperactivity disorder (ADHD) and severe mood dysregulation characterized by chronic, nonepisodic presentations of marked irritability and hyperarousal (2). These findings thereby highlight the future promise of neuroimaging to identify biomarkers of psychiatric illnesses in youth. Read more...