CT scans of first-break psychotic patients in good general health

A computed tomography (CT) scan of the head is often routine for patients with new-onset psychosis to rule out somatic causes. Charts of 127 such patients admitted to a major military medical center were examined. Most patients were young and otherwise in good health. Relationships were examined between CT scan findings and demographic variables, seizure history, neurological abnormalities, and discharge diagnosis. None of the 127 patients had an abnormal scan; four had incidental findings. Incidental findings were strongly associated with ethnic minority status but not with neurologic abnormalities, seizure history, or diagnosis. Findings suggest that routine CT scans for all newly psychotic military patients may not be warranted.