On the usefulness of structural brain imaging for young first episode inpatients with psychosis
Steven Robert Williams, Chad Yukio Koyanagi, Earl Shigemi Hishinuma
Psychiatry Research: Neuroimaging
August 13, 2014
•We examined first-episode psychotic patients without neurological findings.
•Computed tomography (CT) and magnetic resonance imaging (MRI) were used.
•The age range of the sample was from 12 to 30 years old.
•There were no significant nonpsychiatric treatments needed for a sample of 115.
•The diagnostic yield and utility of structural brain imaging was found to be minimal.
The objective of the study was to determine whether structural brain imaging was clinically useful in first episode psychosis (FEP) inpatient adolescents and young adults. The sample (N=115) was from the single largest medical center in the Pacific. A retrospective chart review design was used to review 12- to 30-year-old inpatient admissions with FEP. The primary measurement was whether structural brain imaging with computed tomography (CT) and magnetic resonance imaging (MRI) revealed any remarkable neurological findings related to FEP that led to non-psychiatric treatment. The data analyses entailed comparing the sample prevalence of clinical utility with the expected null hypothesis of a population parameter of 3% utility based on the binomial distribution. The main finding indicated that the sample prevalence of 0% was statistically lower than the null population parameter of 3%. The diagnostic yield and utility of structural brain imaging with younger FEP patients was found to be minimal. Radiation exposure with CT scans and the cost of MRI should be taken into account when evaluating younger FEP patients.