Incidental radiological findings on brain magnetic resonance imaging in first-episode psychosis and chronic schizophrenia

Authors

  • D. I. Lubman,

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
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  • D. Velakoulis,

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
    3. Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia and
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  • P. D. McGorry,

    1. Early Psychosis Prevention and Intervention Centre, The University of Melbourne, Melbourne, Australia
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  • D. J. Smith,

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
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  • W. Brewer,

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
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  • G. Stuart,

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
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  • P. Desmond,

    1. Department of Radiology, Royal Melbourne Hospital & The University of Melbourne, Australia,
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  • B. Tress,

    1. Department of Radiology, Royal Melbourne Hospital & The University of Melbourne, Australia,
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  • C. Pantelis

    1. Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne & Sunshine Hospital, Melbourne, Australia,
    2. Applied Schizophrenia Division, Mental Health Research Institute, Victoria, Australia,
    3. Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia and
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Dr Dan Lubman, Cognitive Neuropsychiatry Research and Academic Unit, Department of Psychiatry, University of Melbourne and Sunshine Hospital, 176 Furlong Road, St Albans, VIC 3021, Australia E-mail: dan.lubman@mh.org.au

Abstract

Objective:  To investigate whether patients with first-episode psychosis or chronic schizophrenia have an increased incidence of magnetic resonance imaging (MRI) brain abnormalities compared with control subjects.

Method:  Totally 340 clinical MRI reports [Controls (n=98), first-episode psychoses (n=152), chronic schizophrenia (n=90)] were reported by a neuroradiologist blind to diagnosis and subsequently categorized using referral criteria (immediate, urgent, routine or no referral).

Results:  Thirty percent of all scans were reported by a neuroradiologist as abnormal, but the majority required no referral. Patients with chronic schizophrenia were more likely to have clinically significant abnormal scans than patients with first episode psychosis or control subjects. In four patients the MRI findings led to the discovery of previously unsuspected pathology.

Conclusion:  Patients with chronic schizophrenia have an increased prevalence of incidental brain abnormalities. A small proportion of patients with chronic schizophrenia and first-episode psychosis benefitted directly from MRI scanning.

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