CT scans in psychiatric patients - an exploratory study at Chris Hani Baragwanath Hospital

Objective. An exploratory study was undertaken to determine the value of computed tomography (CT) in the assessment of mentally ill patients at Chris Hani Baragwanath Hospital Method. All mentally ill inpatients aged 18 years and older who presented during the period March - August 2005, were screened for eligibility for CT of the head. The patients' demographic data, clinical details, special investigations and the results of the CT were recorded. Results. Of approximately 600 admissions, 55 were eligible for CTs during the study period. The mean age of the study population was 38.3 years (standard deviation (SD) 16.3 years). Twenty patients (36.4%) had abnormal CTs; 7 (35%) of these patients were over the age of 60 years. There was a significant correlation between abnormal CTs and advancing age (r = 0.5, p < 0.001). In the group with abnormal CTs the gender distribution was similar, 15 (75%) presented with a first episode of psychosis, 5 (25%) had a concurrent abnormal physical examination, and 7 (35%) had abnormal special investigations. There was no significant difference between this group and the group with normal CTs with regard to gender (c2 = 0.75, p = 0.385), first-episode psychosis (c2 = 2.76, p = 0.096), abnormal physical findings (c2 = 0.51, p = 0.473), or abnormal laboratory findings (c2 = 0.13, p = 0.714) respectively. Conclusion. In this psychiatric population CT scanning revealed a significant number of abnormalities, especially in patients with first-episode psychosis. The study also suggests that clinical abnormalities (physical and laboratory) may not be reliable predictors of abnormal CTs and therefore the need for further research with bigger sample size.