title: An investigation of criteria used to indicate cranial CT in males with schizophrenia.
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.
  
  
  OBJECTIVE
  This study reviews the performance of these criteria.
  
  
  METHODS
  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.
authors.affiliation: 1Centre for Clinical Research in Neuropsychiatry, Mount Claremont, Western Australia.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rock
authors.affiliation: 1Centre for Clinical Research in Neuropsychiatry, Mount Claremont, Western Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Wynn Owen