Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul;39(4):815-9.
doi: 10.1093/schbul/sbs037. Epub 2012 Mar 13.

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

Iris E Sommer  1 , Gérard A P de Kort, Anne Lotte Meijering, Paola Dazzan, Hilleke E Hulshoff Pol, René S Kahn, Neeltje E M van Haren
Affiliations

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

Iris E Sommer et al. Schizophr Bull. 2013 Jul.

Abstract

Background: The 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.

Methods: This 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.

Results: A 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.

Conclusions: This suggests that MRI brain scans are not an essential part of routine screening for psychotic patients.

Keywords: MRI; organic psychosis; psychosis; screening.

PubMed Disclaimer

References

    1. Falkai P. Differential diagnosis in acute psychotic episode. Int Clin Psychopharmacol. 1996;11(suppl 2):13–17. - PubMed
    1. Albon E, Tsourapas A, Frew E, et al. Structural neuroimaging in psychosis: a systematic review and economic evaluation. Health Technol Assess. 2008;12:iii–iv. , ix-163. - PubMed
    1. Johnstone EC, Macmillan JF, Crow TJ. The occurrence of organic disease of possible or probable aetiological significance in a population of 268 cases of first episode schizophrenia. Psychol Med. 1987;17:371–379. - PubMed
    1. Johnstone EC, Cooling NJ, Frith CD, Crow TJ, Owens DG. Phenomenology of organic and functional psychoses and the overlap between them. Br J Psychiatry. 1988;153:770–776. - PubMed
    1. Gaebel W, Falkai P, Weinmann S, Wobrock T. Behandlungsleitlinie Schizophrenie. Darmstadt, Germany: Steinkopff; 2006.

Publication types