Routine brain scanning may improve clinical care for people with psychosis
13 July 2023
Routine brain scanning in people experiencing psychosis could help to identify underlying physical conditions that are causing their symptoms, according to a new study.
Researchers led by Dr Graham Blackman and Prof Philip McGuire at the University of Oxford reviewed the results of over 1,600 patients with a first episode of psychosis who had undergone an MRI brain scan.
They found that around six per cent of patients had a scan abnormality which led to a different diagnosis or a change to their clinical care.
Dr Blackman, an NIHR (National Institute for Health and Care Research) Clinical Lecturer at the University, says: “Patients presenting with psychosis may have another physical illness or condition causing their symptoms that can be identified using MRI scanning. A failure to detect these causes at an early stage can have serious consequences, such as a delay in providing the appropriate treatment. Our findings suggest that MRI scans should be considered as part of the initial assessment of all people with first-episode psychosis to ensure that they get the right diagnosis and the right treatment.”
Although it is considered good practice to carry out a brain scan in new patients with psychosis, this is not mandatory. Previously, a NICE Technology Appraisal was unable to recommend scanning in all patients, as at that time it was unclear how common clinically relevant brain abnormalities in people with first-episode psychosis are.
Prof McGuire added: “We feel that this study addresses a critical knowledge gap in this area by showing that clinically relevant abnormalities occur frequently enough to justify making MRI scanning a routine part of the assessment of people presenting with psychosis for the first time. This new evidence has important implications for clinical care in psychosis and a review of the NICE guidance in this area would be helpful.”
Following these findings, the researchers are now evaluating the utility of offering all people with a first episode of psychosis at Oxford Health NHS Trust an MRI brain scan as part of their initial clinical assessment.
The paper has been published in the journal JAMA Psychiatry.
Notes to editor:
For more details contact Lisa Jones, Communications Manager in the Department of Psychiatry at Oxford University: [email protected] or mobile: 07500 030841.
For out-of-hours media requests contact the Oxford University press office: [email protected] or phone 01865 280528.
This new paper/study ‘Prevalence of neuroradiological abnormalities in First Episode Psychosis’ is available in JAMA Psychiatry here: https://doi.org/10.1001/jamapsychiatry.2023.2225
• The University Department of Psychiatry’s mission is to conduct world-class research, teach psychiatry to medical students, develop future researchers in a graduate programme, teach doctors in training, promote excellence in clinical practice, and develop and provide innovative clinical services. It supports research in four key areas: neurobiology, psychological treatments, developmental psychiatry and social psychiatry. The Department is committed to the translation of scientific discovery into benefits for patients. www.psych.ox.ac.uk
About the University of Oxford
Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the seventh year running, and number 2 in the QS World Rankings 2022. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer. Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.
Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 200 new companies since 1988. Over a third of these companies have been created in the past three years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.
The Department of Biology is a University of Oxford department within the Maths, Physical and Life Sciences Division. It utilises academic strength in a broad range of bioscience disciplines to tackle global challenges such as food security, biodiversity loss, climate change and global pandemics. It also helps to train and equip the biologists of the future through holistic undergraduate and graduate courses. For more information visit www.biology.ox.ac.uk
Professor Anthony Harnden appointed as the new Chair of the MHRA
Study of menstrual tracking app usage highlights potential role in improving access to reproductive health services
Oxford establishes Ashall Professorship in Artificial Intelligence following Ashall donation
Oxford launches new storytelling competition with management and production company, 42
Four Oxford academics receive ERC Synergy Grants to address complex scientific problems