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How can we avoid unnecessary CT scanning for psychiatric patients
The Journal of Clinical Psychiatry
|December 1, 1981
Summary
Brain CT scans may be unnecessary for many psychiatric patients. Normal mental status, neurological exams, and cognitive tests can help identify patients who do not require a CT scan, reducing unnecessary procedures.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Cranial computed tomography (CT) scans are frequently used in psychiatric evaluations.
- Determining the necessity of CT scans in psychiatric patients is crucial for efficient resource allocation and avoiding unnecessary procedures.
Purpose of the Study:
- To evaluate the utility of cranial CT scans in a cohort of psychiatric patients.
- To identify clinical and neurophysiological predictors for excluding patients from CT scans.
Main Methods:
- A cohort of 135 psychiatric patients underwent psychiatric mental status examination (ME), neurological examination (NE), electroencephalogram (EEG), and Canter's Background Interference Procedure for the Bender Gestalt Test (BIP).
- Correlation between examination findings and the necessity of CT scans was analyzed.
Main Results:
- Approximately 25% of psychiatric patients studied did not require a CT scan.
- Patients with normal ME, NE, EEG, and BIP results could be safely excluded from CT scans.
- Patients with normal ME and NE but abnormal BIP or EEG could also be excluded if under 40 years old and without a history of head injury.
Conclusions:
- Normal results across psychiatric, neurological, and specific cognitive/EEG assessments can identify psychiatric patients unlikely to benefit from cranial CT scans.
- Implementing these exclusion criteria could reduce the number of unnecessary CT scans in psychiatric settings, optimizing diagnostic pathways.