Given that the fourth revised edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV-TR) requires the exclusion of general medical
conditions as being responsible for the presenting behavioral changes, attention
to possible medical problems is essential. However, beyond the exclusion of
certain general medical conditions, the EEG has a limited role in the diagnosis of
most axis I or axis II disorders, and it provides little in the way of differentiating
major depression from bipolar disorder or any of the schizophrenia spectrum
disorders. However, it also should be noted that a rather voluminous literature
exists in which the EEGs of variably well-characterized groups of psychiatric
patients were examined, and, in almost all of the studies, the rates of EEG
abnormalities tended to be higher in patient than in non-patient populations.
This is particularly true for a group of controversial waveforms.
Despite the many incidence studies performed, it should be noted that research
focused on identifying the clinical meaning of these various EEG abnormalities
and their diagnostic and prognostic value in a psychiatric context has been
largely lacking. Furthermore, the small amount of research that does address this
area was performed in the 1950s and 1960s,well before the advent of more
sophisticated and restrictive diagnostic criteria and standardized diagnostic
scales. Also, the research that was done suffered from the lack of the ability for
factor analysis of symptom clusters, other diagnostic technology, such as MRI,
and the ability to quantify EEG data collected from large numbers of electrodes.