Department of Psychiatry, John A. Burns School of Medicine, University of Hawai׳i at Mānoa, 1356 Lusitana St., 4th Floor, Honolulu, HI 96813, USA.
Department of Psychiatry, John A. Burns School of Medicine, University of Hawai׳i at Mānoa, 1356 Lusitana St., 4th Floor, Honolulu, HI 96813, USA.
Psychiatry Res. 2014 Nov 30;224(2):104-6. doi: 10.1016/j.pscychresns.2014.08.001. Epub 2014 Aug 13.
The objective of the study was to determine whether structural brain imaging was clinically useful in first episode psychosis (FEP) inpatient adolescents and young adults. The sample (N=115) was from the single largest medical center in the Pacific. A retrospective chart review design was used to review 12- to 30-year-old inpatient admissions with FEP. The primary measurement was whether structural brain imaging with computed tomography (CT) and magnetic resonance imaging (MRI) revealed any remarkable neurological findings related to FEP that led to non-psychiatric treatment. The data analyses entailed comparing the sample prevalence of clinical utility with the expected null hypothesis of a population parameter of 3% utility based on the binomial distribution. The main finding indicated that the sample prevalence of 0% was statistically lower than the null population parameter of 3%. The diagnostic yield and utility of structural brain imaging with younger FEP patients was found to be minimal. Radiation exposure with CT scans and the cost of MRI should be taken into account when evaluating younger FEP patients.
本研究旨在确定结构性脑成像在首发精神病(FEP)住院青少年和年轻成人中的临床应用价值。该样本(N=115)来自太平洋地区最大的单一医疗中心。采用回顾性图表审查设计,对 12 至 30 岁的 FEP 住院患者进行了回顾。主要测量指标是计算机断层扫描(CT)和磁共振成像(MRI)的结构性脑成像是否显示任何与 FEP 相关的显著神经学发现,这些发现导致了非精神科治疗。数据分析包括将样本的临床实用性患病率与基于二项分布的人口参数 3%实用性的预期零假设进行比较。主要发现表明,样本的 0%患病率明显低于零假设的 3%人口参数。对于年轻的 FEP 患者,结构性脑成像的诊断效果和实用性非常有限。在评估年轻的 FEP 患者时,应考虑 CT 扫描的辐射暴露和 MRI 的成本。