Findings in computed Tomography brain scans of patients referred with first-episode Psychosis
Year: 2013
Type: dissertation
Study design: Observational Study
Abstract: Psychosis, the inability to separate subjectivity and reality, can be either functional or organic. \nOrganic psychoses are attributed to physical brain conditions, excluded by imaging. CT \nscanning requires evaluation regarding the detection of organic pathology in South Africa, \nwith its high TB and HIV prevalence and resource limitations. \nAim \nTo determine the prevalence of structural brain abnormalities detected on CT in patients \nreferred with a first-episode psychosis to a tertiary hospital in Johannesburg, South Africa. \nMaterials & Methods \nOne hundred and twelve CT brain scan reports of patients referred over a two-year period, \nafter a first-episode psychosis, were retrospectively reviewed. Demographic data, HIV status, \nspace-occupying lesions (SOL), ventricle size, abnormal calcifications and features of raised \nintra-cranial pressure were recorded. \nResults \nEighty-eight of 112 patients were included in the sample [46 (52.3%) males; mean age 37 \nyears; range 16 – 67 years]. Eleven (20.8%) of the 53 patients evaluated for HIV tested \npositive. Of the 77 patients tested for syphilis, three (3.9%) tested positive. Sixteen (18.8%) \npatients had abnormalities on CT. Only two (2%) were deemed significant findings (a \nhypodensity in the left cerebral peduncle and features of mesiotemporal sclerosis). Three \n(3.4%) patients had enlarged ventricles. Seven (8%) patients had age-inappropriate \ninvolutional changes. Six patients (6.8%) had old calcified granulomata. No SOLs were \ndetected. None had features of raised intra-cranial pressure. \nConclusion \nThe yield of abnormalities in CT brain scans in patients referred with a first-episode \npsychosis at our institution is high. However, only a small percentage of these are significant, \ncan be attributed to the psychosis or affect management.
Authors: Van Wyk, Matthys Johannes
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2248764281