Q. I am reading a book by Daniel Amen, MD (Change Your Brain, Change Your Life). My 26 yr old daughter has BPD, ADD, absent mal epilepsy and has been severely bulimic for 6 years. I would like to know what your opinion is of Dr. Amen's research with SPECT (Single-Photon Computed Tomography ) and depression, impulsivity, anger, etc. I assume that BPD does not show up on a SPECT series but what about the behavioral problems it causes? I would also like to know what your thoughts are on the relationship between ADD and BPD. Do you think that some left temporal lobe damage is behind her many complex problems? I apologize if I threw too many questions at you. Thank you for a most helpful site.

A. SPECT scans are a crude representation of what we see clinically, and there is not any data that credibly supports using SPECT for diagnosis or treatment of ADD or BPD. Any illness from depression to anxiety to schizophrenia can have ADD-like problems. We diagnose clinically based on how a patient presents, not on any blood or radiological (SPECT) test. At this time, SPECT studies in ADD or BPD are research tools at best. The SPECT has been around for years, and no peer reviewed data supports its use as a diagnostic tool or a predictor of treatment outcome in ADD or BPD.