Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-01T22:59:09.877Z Has data issue: false hasContentIssue false
  • English
  • Français

An investigation of criteria used to indicate cranial CT in males with schizophrenia

Published online by Cambridge University Press:  24 June 2014

Daniel J Rock  and
Peter Wynn Owen
Daniel J Rock*
Affiliation:
Centre for Clinical Research in Neuropsychiatry, Mount Claremont, Western Australia
Peter Wynn Owen
Affiliation:
Centre for Clinical Research in Neuropsychiatry, Mount Claremont, Western Australia Graylands Hospital, Mount Claremont, Western Australia
*
Centre for Clinical Research in Neuropsychiatry, Locked Bag no. 1, Claremont, Western Australia, 6910, Australia. Tel. +61 93476429; Fax: +61 93845128; E-mail: danny@ccrn.uwa.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

With the increased accessibility of the CT scanner, psychiatrists managing schizophrenia and first-episode psychosis have incorporated this imaging technique into their diagnostic work-up. This practice has been reinforced by published criteria for CT scanning in psychiatric patients suggesting that cranial CT should be used as a screening tool to exclude intracranial pathology in all patients with a first presentation of schizophrenia or first psychotic episode.

Objectives:

This study reviews the performance of these criteria.

Method:

This consisted of a 3-year retrospective case-note audit, using published criteria, of all male in-patients with an established diagnosis of schizophrenia who had a cranial CT during the review period.

Results:

The efficacy of the published criteria is not supported. In addition, non-specific abnormalities on cranial CT are related to duration of illness and not age in this sample.

Conclusions:

There is a need to establish new and clinically meaningful approaches for the use of cranial CT and similar technologies in clinical psychiatry. Cranial CT performs poorly as a universal screening tool in this population. The decision to use such imaging techniques should be made on a case-by-case basis using all available clinical evidence.

Keywords

brainpathologyschizophreniadiagnosistomographyX-ray computed
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 5 , October 2003 , pp. 284 - 289
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kraepelin, E. Dementia Praecox and Paraphrenia. (translated by R.M. Barklay). Edinburgh: Livingstone, 1919. Google Scholar
Shenton, ME, Dickey, CC, Frumin, M, McCarley, RW. A review of MRI findings in schizophrenia. Schizophr Res 2001;49: 1–52.CrossRefGoogle Scholar
Haug, JO. Pneumoencephalographic studies in mental disease. Acta Psychiatrica Scand 1962;38: 1–114. Google ScholarPubMed
Copolov, D, Crook, J. Biological markers and schizophrenia. Aust NZ J Psychiatry 2000;34: S108–S112. CrossRefGoogle Scholar
Abrams, HL, McNeil, BJ. Medical implications of computed tomography (‘CAT’ scanning). N Engl J Med 1978;298: 255–261.CrossRefGoogle Scholar
Johnstone, EC, Crow, TJ, Frith, CD, Husband, J, Kreel, L. Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet 1976;2: 924–926.CrossRefGoogle ScholarPubMed
Owens, DG C, Johnstone, EC, Bydder, GM, Kreel, L. Unsuspected organic disease in chronic schizophrenia demonstrated by computed tomography. J Neurol Neurosurg Psychiatry 1980;43: 1065–1069.CrossRefGoogle Scholar
Larson, EB, Mack, LA, Watts, B, Cromwell, LD. Computed tomography in patients with psychiatric illnesses. Advantage of a “rule-in” approach. Ann Intern Med 1981;95: 360–364.CrossRefGoogle ScholarPubMed
Holt, RE, Rawat, S, Beresford, TP, Hall, RCW. Computed tomography of the brain and the psychiatric consultation. Psychosomatics 1982;23: 1007–1019.CrossRefGoogle ScholarPubMed
Weinberger, DR. Brain disease and psychiatric illness. When should a psychiatrist order a CAT scan? Am J Psychiatry 1984;141: 1521–1527.Google Scholar
Johnstone, EC, Macmillan, JF, Crow, TJ. The occurrence of organic disease of aetiological significance in a population of 268 cases of first episode schizophrenia. Psychol Med 1987;17: 371–379.CrossRefGoogle Scholar
Falkai, P. Differential diagnosis in acute psychotic episode. Int Clin Psychopharmacol 1996;11: 13–17.CrossRefGoogle ScholarPubMed
Tsai, L, Tsuang, MT. How can we avoid unnecessary CT scanning for psychiatric patients? J Clin Psychiatry 1981;42: 452–454.Google ScholarPubMed
Ananth, J, Gamal, R, Miller, M, Wohl, M, Vandewater, S. Is the routine CT head scan justified for psychiatric patients? A prospective study. J Psychiatry Neurosci 1993;18: 69–73.Google ScholarPubMed
Bain, BK. CT scans of first-break psychotic patients in good general health. Psychiatr Serv 1998;49: 234–235.CrossRefGoogle ScholarPubMed
Marik, PE, Rakusin, A, Sandhu, SS. The impact of the accessibility of cranial CT scans on patient evaluation and management decisions. J Int Med 1997;241: 237–243. CrossRefGoogle ScholarPubMed
Gewirtz, G, Squires-Wheeler, E, Sharif, Z, Honer, WG. Results of computerised tomography during first admission for psychosis. Br J Psychiatry 1994;164: 789–795.CrossRefGoogle Scholar
Colohan, H, O'Callaghan, E, Larkin, C, Waddington, JL. An evaluation of cranial CT scanning in clinical psychiatry. Irish J Med Sci 1989;158: 178–181.CrossRefGoogle ScholarPubMed
Goodstein, RK. Guide to CAT scanning in hospital psychiatry. Overview of clinical practice and criteria for use. General Hosp Psychiatry 1985;7: 367–376. CrossRefGoogle ScholarPubMed
National Center for Health Statistics (US). International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Ann Arbor: The Center, 1987. Google ScholarPubMed
Kirkby, KC, Hay, DA, Daniels, BA, Jones, IH, Mowry, BJ. Comparison between register and structured interview diagnoses of schizophrenia: a case for longitudinal diagnostic profiles. Austr N Zealand J Psychiatry 1998;32: 410–414. CrossRefGoogle ScholarPubMed
National Health and Medical Research Council. National. Statement of Ethical Conduct in Research Involving Humans. Canberra: Commonwealth of Australia, 1999. Google ScholarPubMed
Medcalc Software. Medcalc (Computer Program), Version 6.12. Mariakerke (Belgium): Medcalc Software, 2000. Google Scholar