The request of diagnostic imagining techniques, such as CT, is sometimes necessary when working in the emergency service as a psychiatrist. Common circumstances that need CT are altered level of consciousness, absence of psychiatric history, sudden beginning of the symptoms or visual hallucinations.

To study the profitability of the cranial CT for patients with psychiatric symptoms in the Emergency Service.

Retrospective review of the cranial CT was made to patients who presented psychiatric symptoms in the Emergency Service of our hospital from November 2009 to July 2010 using Hospital Ramon Cajal’s history software.

We collected a total of 94 patients.-Sex: there were no important differences, 45,7% were women and 53,3% were men. -Age: < 18 years (3,2%), 18–30 years (12,8%), 31–40 (7,4%), 41–50 (26,6%), 51–60 (17%), 61–70 (14,9%), >71 (18,1%) Cause of consulting: The most frequent cause of consulting was “behavior disorder” (35,1%) and psychotic symptoms (14,9%). Other causes were altered level of consciousness and neurological symptoms.

Image findings: It stands out that up to a 63,8% of the patients had no significant radiological findings. The most frequent diagnosis (26,6%) was cortical-subcortical atrophy, followed by vascular cerebral illness in 9,6%.

Diagnosis: 20,2% were diagnosticated of psychotic disorder, 11,7% neurological disorder and 10,6% dementia.

1. - Only in 6,4% of the cases the image results were indispensable to reach a correct diagnosis.

2. - Cranial CT requests should not be made routinely and guides should be followed more strictly.