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The Psychiatrist in the Machine

Software rivals doctors at distinguishing among different kinds of depression and schizophrenia

4 min read
image of brain
Hard Evidence: Psychiatrists want to diagnose patients based on their physiology rather than subjective symptoms. Images of the brain and the electric signals that emanate from it could be key to picking the right treatments for depression and schizophrenia
Illustration: Don Farrall/Getty Images

Psychiatrists make life-altering decisions on the basis of a subjective assessment of a set of symptoms. But many freely admit they have far too little information to answer some critical questions: Is the patient suffering from severe depression, or is this a case of bipolar disorder that hasn’t fully manifested itself yet? Will this schizophrenic patient respond to this drug? Draw the wrong conclusions about a depressed patient and the treatment may send him careening into mania. Make the wrong assessment of a schizophrenic person and you may give him an ineffective drug whose side effects could kill him.

“I make these decisions every day,” says Dr. Gary Hasey, associate professor of psychiatry at McMaster University, in Hamilton, Ont., Canada. “If you make an error, you stand a good chance of making things worse.”

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Restoring Hearing With Beams of Light

Gene therapy and optoelectronics could radically upgrade hearing for millions of people

13 min read
A computer graphic shows a gray structure that’s curled like a snail’s shell. A big purple line runs through it. Many clusters of smaller red lines are scattered throughout the curled structure.

Human hearing depends on the cochlea, a snail-shaped structure in the inner ear. A new kind of cochlear implant for people with disabling hearing loss would use beams of light to stimulate the cochlear nerve.

Lakshay Khurana and Daniel Keppeler
Blue

There’s a popular misconception that cochlear implants restore natural hearing. In fact, these marvels of engineering give people a new kind of “electric hearing” that they must learn how to use.

Natural hearing results from vibrations hitting tiny structures called hair cells within the cochlea in the inner ear. A cochlear implant bypasses the damaged or dysfunctional parts of the ear and uses electrodes to directly stimulate the cochlear nerve, which sends signals to the brain. When my hearing-impaired patients have their cochlear implants turned on for the first time, they often report that voices sound flat and robotic and that background noises blur together and drown out voices. Although users can have many sessions with technicians to “tune” and adjust their implants’ settings to make sounds more pleasant and helpful, there’s a limit to what can be achieved with today’s technology.

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