title: How frequent are radiological abnormalities in patients with psychosis? A review of 1379 MRI scans.
abstract: BACKGROUND
  The term psychosis refers to a combination of symptoms, without pointing to the origin of these symptoms. In a subset of psychotic patients, symptoms are attributable to an organic disease. It is important to identify these organic causes of psychosis early, as urgent treatment of the primary disease may be required. Some of these underlying organic disorders can be identified on magnetic resonance imaging (MRI) scans. Whether routine screening for all psychotic patients should therefore include MRI scans is still a matter of debate.
  
  
  METHODS
  This study investigated the prevalence of clinically relevant abnormalities detected on MRI scans from psychotic patients and a matched control group. We could include MRI scans from 656 psychotic patients and 722 controls. The standard radiological reports of these scans were classified as normal, as a nonrelevant abnormality or as a clinically relevant brain abnormality by means of consensus, blind to diagnosis.
  
  
  RESULTS
  A normal aspect of the brain was reported in 74.4% of the patients and in 73.4% of the controls. We found clinically relevant pathology in 11.1% of the patients and in 11.8% of the controls. None of the neuropathological findings observed in the patients was interpreted as a possible substrate for organic psychosis. Brain abnormalities that were classified as not clinically relevant were identified in 14.5% of the patients and in 14.8% of the controls.
  
  
  CONCLUSIONS
  This suggests that MRI brain scans are not an essential part of routine screening for psychotic patients.
authors.affiliation: Psychiatry Department, University Medical Center Utrecht and Rudolf Magnus Institute for Neuroscience, The Netherlands. I.Sommer@umcutrecht.nl
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
authors.forename: Gérard A P
authors.initials: GA
authors.lastname: de Kort
authors.forename: Anne Lotte
authors.initials: AL
authors.lastname: Meijering
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.forename: Hilleke E
authors.initials: HE
authors.lastname: Hulshoff Pol
authors.forename: René S
authors.initials: RS
authors.lastname: Kahn
authors.forename: Neeltje E M
authors.initials: NE
authors.lastname: van Haren
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis / Q000473:pathology*; D012559:Schizophrenia / Q000175:diagnosis / Q000473:pathology*; D055815:Young Adult