How frequent are radiological abnormalities in patients with psychosis? A review of 1379 MRI scans

Iris E. Sommer*, Gérard A.P. De Kort, Anne Lotte Meijering, Paola Dazzan, Hilleke E. Hulshoff Pol, René S. Kahn, Neeltje E.M. Van Haren

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

41 Citations (Scopus)

Abstract

BackgroundThe term psychosis refers to a combination of symptoms, without pointing to the origin of these symptoms. In a subset of psychotic patients, symptoms are attributable to an organic disease. It is important to identify these organic causes of psychosis early, as urgent treatment of the primary disease may be required. Some of these underlying organic disorders can be identified on magnetic resonance imaging (MRI) scans. Whether routine screening for all psychotic patients should therefore include MRI scans is still a matter of debate.MethodsThis study investigated the prevalence of clinically relevant abnormalities detected on MRI scans from psychotic patients and a matched control group. We could include MRI scans from 656 psychotic patients and 722 controls. The standard radiological reports of these scans were classified as normal, as a nonrelevant abnormality or as a clinically relevant brain abnormality by means of consensus, blind to diagnosis.ResultsA normal aspect of the brain was reported in 74.4% of the patients and in 73.4% of the controls. We found clinically relevant pathology in 11.1% of the patients and in 11.8% of the controls. None of the neuropathological findings observed in the patients was interpreted as a possible substrate for organic psychosis. Brain abnormalities that were classified as not clinically relevant were identified in 14.5% of the patients and in 14.8% of the controls.ConclusionsThis suggests that MRI brain scans are not an essential part of routine screening for psychotic patients.

Original languageEnglish
Pages (from-to)815-819
Number of pages5
JournalSchizophrenia Bulletin
Volume39
Issue number4
DOIs
Publication statusPublished - Jul 2013
Externally publishedYes

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