Clinical use of neuro-imaging in psychiatric patients at the Charlotte Maxeke Johannesburg Academic Hospital

South African Journal of Psychiatry

Field Value
Title Clinical use of neuro-imaging in psychiatric patients at the Charlotte Maxeke Johannesburg Academic Hospital
Creator Letlotlo, Bokang L. Lumu, Lavinia D. Moosa, Mahomed Y. Jeenah, Fatima Y.
Subject Psychiatry; Neuropsychiatry; Neuroimaging neuro-imaging; CT scans; psychiatric disorders; guidelines; a yield of abnormal scans; factors associated with abnormal scans; resource constraints; cost-effectiveness
Description Background: Neuro-imaging is relatively new in psychiatry. Although the actual role of neuro-imaging in psychiatry remains unclear, it is used to strengthen clinical evidence in making psychiatric diagnoses.Aim: To analyse the records of inpatients referred for neuro-imaging (computerised tomography [CT] and/or magnetic resonance imaging [MRI] scans) to determine the proportion of abnormal neuro-imaging results and, if any, factors associated with abnormal neuro-imaging results.Setting: This study was conducted at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) situated in Johannesburg, South Africa.Methods: This was a quantitative retrospective record review. All adult psychiatric inpatients who had undergone a CT and/or MRI scan during 01 January 2014 to 31 December 2015 were included. Out-patients or patients admitted in the medical wards were excluded from the study. All neuro-imaging referrals were identified from hospital records and their demographics, scan characteristics and diagnoses were subsequently captured.Results: A total of 1040 patients were admitted to the CMJAH psychiatric unit, of which 213 (20.5%) underwent neuro-imaging tests. Of the 213 scans performed, 74 were abnormal, representing a yield of 34.7%. The most common reported pathology was atrophy (n = 22, 29.7%). There was no statistically significant association between age group (χ2 = 3.9, p = 0.8), gender (χ2 = 1.3; p = 0.5), psychiatric diagnoses and abnormal scans. However, there were trends towards an association with comorbid HIV infection (χ2 = 3.476, p = 0.062) and comorbid substance abuse (χ2 = 2.286, p = 0.091).Conclusion: This study supports the need for clear clinical indications to justify the cost-effective use of neuro-imaging in psychiatry. This study’s high yield of abnormal CT scans, although similar to other studies, advocates that HIV positive testing and the presence of focal neurological signs will improve the yield further.
Publisher AOSIS
Date 2021-05-28
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — quantitative research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajpsychiatry.v27i0.1614
Source South African Journal of Psychiatry; Vol 27 (2021); 8 pages 2078-6786 1608-9685
Language eng
Coverage Africa; South Africa; Gauteng; Johannesburg health district; Charlotte Maxeke Johannesburg Academic Hospital January 2014-December 2015 adult patients; over 18 years old; inpatients
Rights Copyright (c) 2021 Bokang L. Letlotlo, Lavinia D. Lumu, Mahomed Y.H. Moosa, Fatima Y. Jeenah