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Results of Computerised Tomography During First Admission for Psychosis

Published online by Cambridge University Press:  02 January 2018

George Gewirtz ,
Elizabeth Squires-Wheeler ,
Zafar Sharif  and
William G. Honer
George Gewirtz
Affiliation:
College of Physicians and Surgeons, Columbia University
Elizabeth Squires-Wheeler
Affiliation:
College of Physicians and Surgeons, Columbia University, and Department of Medical Genetics, New York State Psychiatric Institute
Zafar Sharif
Affiliation:
College of Physicians and Surgeons, Columbia University, and Schizophrenia Research Unit, Creedmoor Psychiatric Center
William G. Honer*
Affiliation:
Department of Psychiatry, University of British Columbia, and College of Physicians and Surgeons, Columbia University
*
∗Department of Psychiatry, University of British Columbia, 2660 Oak Street, Vancouver, BC, Canada V6K 3Z6
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Abstract

A cohort of 168 psychotic patients underwent computerised tomography (CT) during their first admission. Cortical atrophy was present in 40% of patients. The frequency of atrophy increased with age, but did not differ between patients with schizophrenia, schizoaffective disorder, bipolar disorder or psychotic depression. Other CT findings of note were present in 6.6% of patients, and included four infarctions, three arachnoid cysts, and one each of venous angioma, colloid cyst, cavum vergae and post-traumatic changes. The frequency of CT findings other than atrophy was increased in the psychotic depression group. The findings support the proposal of the onset of psychosis being an indication for CT.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 6 , June 1994 , pp. 789 - 795
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA Press.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA Press.Google Scholar
Ananth, J., Gamal, R., Miller, M. et al (1993) Is the routine CT head scan justified for psychiatric patients? Journal of Psychiatry and Neuroscience, 18, 69–73.Google Scholar
Andreasen, N. C., Swayze, V. W., Flaum, M. et al (1990) Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning. Archives of General Psychiatry, 47, 1008–1015.Google Scholar
Bartko, J. J. & Carpenter, W. T. (1976) On the methods and theory of reliability. Journal of Nervous and Mental Disease, 163, 307–317.Google Scholar
Battaglia, J. & Spector, I. C. (1988) Utility of the CAT scan in a first psychotic episode. General Hospital Psychiatry, 10, 398–401.Google Scholar
Beresford, T. P., Blow, F. C., Hall, R. C. W., et al (1986) CT scanning in psychiatric inpatients: clinical yield. Psychosomatics, 27, 105–112.CrossRefGoogle ScholarPubMed
Beresford, T. P., Blow, F. C., Hall, R. C. W., et al (1988) CT scanning in psychiatric inpatients: II. Clinical data predicting scan results. Psychosomatics, 29, 321–327.CrossRefGoogle ScholarPubMed
Berthier, M. L., Starkstein, S. E., Robinson, R. G., et al (1990) Limbic lesions in a patient with recurrent mania. Journal of Neuropsychiatry and Clinical Neuroscience, 2, 235–236.Google Scholar
Bourgeois, J. A., Nisenbaum, J., Drexler, K. G., et al (1992) A case of subcortical grey matter heterotopia presenting as bipolar disorder. Comprehensive Psychiatry, 33, 407–410.Google Scholar
Burkle, F. M. & Lipowski, Z. J. (1978) Colloid cyst of the third ventricle presenting as psychiatric disorder. American Journal of Psychiatry, 135, 373–375.Google Scholar
Burns, A., Jacoby, R., Philpot, M., et al (1991) Computerised tomography in Alzheimer's disease. British Journal of Psychiatry, 159, 609–614.Google Scholar
Coffey, C. E., Wilkinson, W.E., Weiner, R. D., et al (1993) Quantitative cerebral anatomy in depression. Archives of General Psychiatry, 50, 7–16.Google Scholar
Coffman, J. A. (1989) Computed tomography. In Brain Imaging: Applications in Psychiatry (ed. Andreasen, N. C.), pp. 1–66. Washington, DC: American Psychiatric Press.Google Scholar
David, A. S., Wacharasindhu, A. & Lishman, W. A. (1993) Severe psychiatric disturbance and abnormalities of the corpus callosum: review and case series. Journal of Neurology, Neurosurgery and Psychiatry, 56, 85–93.CrossRefGoogle ScholarPubMed
DeCarli, C., Kaye, J. A., Horowitz, B. et al (1990) Critical analysis of the use of computer-assisted transverse axial tomography in aging and dementia of the Alzheimer type. Neurology, 40, 872–883.CrossRefGoogle ScholarPubMed
Degreef, G., Bogerts, B., Falkai, P., et al (1992) Increased prevalence of the cavum septum pellucidum in magnetic resonance scans and post-mortem brains of schizophrenic patients. Psychiatry Research: Neuroimaging, 45, 1–13.Google Scholar
Evans, N. J. R. (1982) Cranial computerized tomography in clinical psychiatry: 100 consecutive cases. Comprehensive Psychiatry, 23, 445–450.Google Scholar
Feinstein, A. & Ron, M. A. (1990) Psychosis associated with demonstrable brain disease. Psychological Medicine, 20, 793–803.Google Scholar
George, M. S., Scott, T., Kellner, C. H., et al (1989) Abnormalities of the septum pellucidum in schizophrenia. Journal of Neuropsychiatry and Clinical Neuroscience, 1, 385–390.Google Scholar
Hoffman, W. F., Burry, M. T., Keepers, G. A., et al (1991) Unexpected intracerebral pathology in older schizophrenic patients. American Journal of Psychiatry, 148, 390–391.Google Scholar
Hollister, L. E. & Boutros, N. (1991) Clinical use of CT and MRI scans in psychiatric patients. Journal of Psychiatry and Neuroscience, 16, 194–198.Google ScholarPubMed
Holt, R. E., Rawat, S., Beresford, T. P., et al (1982) Computed tomography and the psychiatric consultation. Psychosomatics, 23, 1007–1019.CrossRefGoogle ScholarPubMed
Iacono, W. G., Smith, G. N., Moreau, M., et al (1988) Ventricular and sulcal size at the onset of psychosis. American Journal of Psychiatry, 145, 820–824.Google Scholar
Jacoby, R. J., Levy, R., & Bird, J. M. (1981) Computer tomography and the outcome of affective disorder: a follow-up of elderly patients. British Journal of Psychiatry, 139, 288–292.Google Scholar
Jeste, D. V., Lohr, J. B. & Goodwin, F. K. (1988) Neuroanatomical studies of major affective disorders. British Journal of Psychiatry, 153, 444–459.Google Scholar
Jurjus, G. J., Nasrallah, H. A., Olson, S. C., et al (1993) Cavum septum pellucidum in schizophrenia, affective disorder and healthy controls: a magnetic resonance imaging study. Psychological Medicine, 23, 319–322.CrossRefGoogle ScholarPubMed
Larson, E. B., Mack, L. A., Watts, B., et al (1981) Computed tomography in patients with psychiatric illness: advantage of a ‘rule-in$’ approach. Annals of Internal Medicine, 95, 360–364.Google Scholar
Lee, D., Fox, A., Vinuela, F., et al (1987) Interobserver variation in computed tomography of the brain. Archives of Neurology, 44, 30–31.CrossRefGoogle ScholarPubMed
Lewis, S. W. (1986) A Comparison of Schizophrenia with and without Intracranial Abnormalities on Computerised Tomography. M Phil thesis, University of London.Google Scholar
Lewis, S. W. (1989) Congenital risk factors for schizophrenia. Psychological Medicine, 19, 5–13 CrossRefGoogle ScholarPubMed
Lewis, S. W. (1990) Computerised tomography in schizophrenia 15 years on. British Journal of Psychiatry, 157 (supplement 9), 16–24.Google Scholar
Lieberman, J., Bogerts, B., Degreef, G., et al (1992) Qualitative assessment of brain morphology in acute and chronic schizophrenia. American Journal of Psychiatry, 149, 784–794.Google Scholar
Lishman, W. A. (1987) Organic Psychiatry. Oxford: Blackwell.Google Scholar
McClellan, R. L., Eisenberg, R. L. & Giyanani, V. L. (1988) Routine CT screening of psychiatry inpatients. Radiology, 169, 99–100.Google Scholar
Meltzer, H. Y. (1992) Treatment of the neuroleptic-nonresponsive schizophrenic patient. Schizophrenia Bulletin, 18, 515–542.CrossRefGoogle ScholarPubMed
Morris, P. & Rapoport, S. I. (1990) Neuroimaging and affective disorder in late life: a review. Canadian Journal of Psychiatry, 35, 347–354.Google Scholar
Motohashi, N., Ishizuka, Y., Asada, T., et al (1990) A case of aqueduct stenosis in adults with various neurological and psychiatric symptoms. European Archives of Psychiatry and Clinical Neuroscience, 240, 13–15.Google Scholar
Nasrallah, H. A., Coffman, J. A. & Olson, S. C. (1989) Structural brain-imaging findings in affective disorders: an overview. Journal of Neuropsychiatry and Clinical Neuroscience, 1, 21–26.Google ScholarPubMed
Owens, D. G. C., Johnstone, E. C., Bydder, G. M., et al (1980) Unsuspected organic disease in chronic schizophrenia demonstrated by computed tomography. Journal of Neurology, Neurosurgery and Psychiatry, 43, 1065–1069.Google Scholar
Pearlson, G. D., Kim, W. S., Kubos, K. L., et al (1989) Ventricle-brain ratio, computed tomographic density, and brain area in 50 schizophrenics. Archives of General Psychiatry, 46, 690–697.CrossRefGoogle ScholarPubMed
Rieder, R. O., Mann, L. S., Weinberger, D. R., et al (1983) Computed tomographic scans in patients with schizophrenia, schizoaffective, and bipolar affective disorder. Archives of General Psychiatry, 40, 735–739.Google Scholar
Roberts, J. K. A. & Lishman, W. A. (1985) The use of the CAT head scanner in clinical psychiatry. British Journal of Psychiatry, 145, 152–158.Google Scholar
Shelton, R. C. & Weinberger, D. R. (1986) X-ray computerized tomography studies in schizophrenia: a review and synthesis. In Handbook of Schizophrenia, Vol. 1: The Neurology of Schizophrenia (eds Nasrallah, H. A. & Weinberger, D.R.), pp. 207–250. Amsterdam: Elsevier.Google Scholar
Smith, G. N., Iacono, W. G., Moreau, M., et al (1988) Choice of comparison group and findings of computerised tomography in schizophrenia. British Journal of Psychiatry, 153, 667–674.Google Scholar
Swayze, V. W., Andreasen, N. C., Ehrhardt, J. C., et al (1990) Developmental abnormalities of the corpus callosum in schizophrenia. Archives of Neurology, 47, 805–808.Google Scholar
Tsai, L. & Tsuang, M. T. (1981) How can we avoid unnecessary CT scanning for psychiatric patients? Journal of Clinical Psychiatry, 42, 452–454.Google Scholar
Vaillant, G. (1965) Schizophrenia in a woman with temporal lobe arterio-venous malformations. British Journal of Psychiatry, 111, 307–308.Google Scholar
Vita, A., Dieci, M., Giobbio, G. M., et al (1991) CT scan abnormalities and outcome of chronic schizophrenia. American Journal of Psychiatry, 148, 1577–1579.Google ScholarPubMed
Waddington, J. L. (1993) Neurodynamics of abnormalities in cerebral metabolism and structure in schizophrenia. Schizophrenia Bulletin, 19, 55–69.CrossRefGoogle ScholarPubMed
Weinberger, D. R. (1984) Brain disease and psychiatric illness: when should a psychiatrist order a CAT scan? American Journal of Psychiatry, 141, 1521–1527.Google Scholar
Woods, B. T. & Short, B. T. & Short, M. P. (1985) Neurological dimensions of psychiatry. Biological Psychiatry, 20, 192–198.Google Scholar
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