title: Brain imaging in psychiatry - a study of 435 psychiatric in-patients at a university clinic.
abstract: OBJECTIVE
  The use of brain imaging in psychiatry still lacks clear guidelines. We investigated the referral practice, outcome and predictive factors of neuroimaging in a Swiss psychiatric university clinic.
  
  
  METHODS
  Medical files were reviewed retrospectively for 435 consecutively hospitalized patients who were subjected to neuroimaging. The association between the sociodemographic and clinical characteristics and the scan results was analyzed using bivariate and multivariate analyses.
  
  
  RESULTS
  Of overall examinations, 69.4% were normal, 16.3% equivocal and 14.3% abnormal; 2.9% of scans ordered for screening only showed pathology. Neurologic signs and advanced age of patients predicted abnormal scan findings, whereas other variables such as EEG results showed no significant association.
  
  
  CONCLUSIONS
  Our results support the need for clear indications for using brain imaging in psychiatric in-patients. Focal neurologic signs and advanced patient age seems to predict abnormal scan results. However, these criteria are not sufficiently sensitive to predict significant scan findings in all patients.
authors.affiliation: Psychiatric Outpatient Department, University Hospital, Zürich, Switzerland. christoph.mueller2@usz.ch
authors.forename: C
authors.initials: C
authors.lastname: Mueller
authors.forename: M
authors.initials: M
authors.lastname: Rufer
authors.forename: H
authors.initials: H
authors.lastname: Moergeli
authors.forename: R
authors.initials: R
authors.lastname: Bridler
mesh_terms: D000328:Adult; D001921:Brain / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology; D046589:CADASIL / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011570:Psychiatry / Q000295:instrumentation*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed