Routine Brain Scan Improves Psychosis Clinical Care

The results of almost 1,600 individuals with a first episode of psychosis who had undergone an MRI brain scan were analyzed by researchers led by Dr Graham Blackman and Professor Philip McGuire at the University of Oxford.

They discovered that approximately 6% of patients had a scan abnormality, which resulted in a new diagnosis or a change in their therapeutic management.

Dr Blackman, an NIHR (National Institute for Health and Care Research) Clinical Lecturer at the University, says:“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.”

Although performing a brain scan on new patients with psychosis is considered best practice, it is not required. Previously, a NICE Technology Appraisal was unable to suggest scanning in all patients since it was unclear at the time how common clinically important brain abnormalities are in persons with first-episode psychosis.

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.”

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