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Br J Psychiatry. 2017 Oct;211(4):231-237. doi: 10.1192/bjp.bp.116.195834. Epub 2017 May 4.

Clinical utility of magnetic resonance imaging in first-episode psychosis.

Author information

1
Irina Falkenberg, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany; Stefania Benetti, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Marie Raffin, MD, Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France; Phillipe Wuyts, MD, EDHEC Business School, Nice, France; William Pettersson-Yeo, PhD, Paola Dazzan, MBChB, MSc, MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Kevin D. Morgan, PhD, Department of Psychology, University of Westminster, London, UK; Robin M. Murray, MBChB, MPhil, FRCPsych, Tiago Reis Marques, PhD, Anthony S. David, FRCP, FRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Jozef Jarosz, MD, Department of Neuroimaging, South London and Maudsley NHS Foundation Trust, London and Department of Neuroimaging Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Andrew Simmons, PhD, Steve Williams, Professor, Department of Neuroimaging Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Philip McGuire, Professor, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK irina.falkenberg@med.uni-marburg.de.
2
Irina Falkenberg, MD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany; Stefania Benetti, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Marie Raffin, MD, Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France; Phillipe Wuyts, MD, EDHEC Business School, Nice, France; William Pettersson-Yeo, PhD, Paola Dazzan, MBChB, MSc, MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Kevin D. Morgan, PhD, Department of Psychology, University of Westminster, London, UK; Robin M. Murray, MBChB, MPhil, FRCPsych, Tiago Reis Marques, PhD, Anthony S. David, FRCP, FRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Jozef Jarosz, MD, Department of Neuroimaging, South London and Maudsley NHS Foundation Trust, London and Department of Neuroimaging Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Andrew Simmons, PhD, Steve Williams, Professor, Department of Neuroimaging Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Philip McGuire, Professor, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Abstract

BackgroundThere is no consensus as to whether magnetic resonance imaging (MRI) should be used as part of the initial clinical evaluation of patients with first-episode psychosis (FEP).Aims(a) To assess the logistical feasibility of routine MRI; (b) to define the clinical significance of radiological abnormalities in patients with FEP.MethodRadiological reports from MRI scans of two FEP samples were reviewed; one comprised 108 patients and 98 healthy controls recruited to a research study and the other comprised 241 patients scanned at initial clinical presentation plus 66 healthy controls.ResultsIn the great majority of patients, MRI was logistically feasible. Radiological abnormalities were reported in 6% of the research sample and in 15% of the clinical sample (odds ratio (OR)=3.1, 95% CI 1.26-7.57, χ2(1) = 6.63, P = 0.01). None of the findings necessitated a change in clinical management.ConclusionsRates of neuroradiological abnormalities in FEP are likely to be underestimated in research samples that often exclude patients with organic abnormalities. However, the majority of findings do not require intervention.

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PMID:
28473319
DOI:
10.1192/bjp.bp.116.195834
[Indexed for MEDLINE]

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