Routine brain scans in people experiencing psychosis could help to identify the underlying conditions that cause their symptoms, a new UK study has claimed.
University of Oxford, UK, researchers found about 6% of patients with a first episode of psychosis who underwent an MRI brain scan had a scan abnormality which led to a different diagnosis or a change to their clinical care.
Writing in the latest edition of JAMA Psychiatry, the researchers say their results suggest MRI scans could form part of the initial assessment of individuals with first-episode psychosis.
Dr Graham Blackman, who led the study with Professor Philip McGuire, said: “Patients presenting with psychosis may have another physical illness or condition causing their symptoms that can be identified using MRI scanning.
“A failure to detect these causes at an early stage can have serious consequences, such as a delay in providing the appropriate treatment. Our findings suggest that MRI scans should be considered as part of the initial assessment of all people with first-episode psychosis to ensure that they get the right diagnosis and the right treatment.”
It is not mandatory to carry out a brain scan in new patients with psychosis and a NICE Technology Appraisal did not recommend scanning in all patients because it was unclear how common clinically relevant brain abnormalities in people with first-episode psychosis are.
Prof McGuire added: “We feel that this study addresses a critical knowledge gap in this area by showing that clinically relevant abnormalities occur frequently enough to justify making MRI scanning a routine part of the assessment of people presenting with psychosis for the first time. This new evidence has important implications for clinical care in psychosis and a review of the NICE guidance in this area would be helpful.”
Blackman G, Neri G, Al-Doori O et al. Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis. A Systematic Review and Meta-analysis. JAMA Psychiatry 12 July 2023.
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