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Computed tomography in psychiatric patients.

R A Emsley, D Stander, P S Bell

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |August 16, 1986
    PubMed
    Summary

    Computed tomography (CT) revealed intracranial abnormalities in 61% of psychiatric patients. Focal lesions, linked to alcohol abuse and trauma, impacted management, highlighting the need for broader CT referral criteria in psychiatry.

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    Area of Science:

    • Neurology
    • Psychiatry
    • Radiology

    Background:

    • Computed tomography (CT) is a crucial diagnostic tool for identifying intracranial lesions.
    • Psychiatric patients may present with neurological symptoms that warrant neuroimaging.
    • Previous studies have explored the utility of CT in specific psychiatric populations.

    Purpose of the Study:

    • To evaluate the prevalence and characteristics of intracranial abnormalities in adult psychiatric patients.
    • To determine the association of focal lesions with clinical factors such as alcohol abuse, head trauma, and neurological signs.
    • To assess the impact of CT findings on patient management and treatment decisions.

    Main Methods:

    • Retrospective analysis of 100 consecutive adult psychiatric patients.
    • Review of computed tomography (CT) scans for suspected intracranial lesions.
    • Correlation of CT findings with patient history, neurological examination, and electroencephalogram (EEG) results.

    Main Results:

    • Abnormalities were detected in 61% of patients.
    • Focal lesions were identified in 23% of the study cohort.
    • Significant associations were found between focal lesions and alcohol abuse, previous craniocerebral trauma, and focal neurological signs.
    • CT findings influenced patient management in over 50% of cases.
    • The correlation between electroencephalogram (EEG) and CT results was weak.

    Conclusions:

    • Computed tomography (CT) is valuable in detecting significant intracranial pathology in psychiatric patients.
    • Clinical factors like alcohol abuse and head trauma are associated with focal brain lesions.
    • Restrictive CT referral criteria may lead to missed diagnoses of occult brain disease in this population.
    • Neuroimaging should be considered judiciously in psychiatric patients presenting with relevant clinical indicators.

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