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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*
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: [email protected]

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.

Type
Research Article
Copyright
Copyright © 2003 Blackwell Munksgaard

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