How Common Are Abnormal Brain MRI Findings in Patients with First Episodes of Psychosis?

Consensus is lacking on whether all patients with first episodes of psychosis should undergo brain magnetic resonance imaging (MRI) to exclude underlying structural brain abnormalities. In this systematic review and meta-analysis, investigators determined the prevalence of clinically relevant brain MRI findings in patients with first episodes of psychosis. Clinically relevant abnormalities were those that “led to a change in management... or diagnosis.”

Overall, 12 studies that involved 1600 patients (mean ages, 20–60) with first episodes of psychosis who underwent brain MRI were included in the analysis. Of these patients, 26% had intracranial radiological abnormalities, and 6% had clinically relevant abnormalities. The most common clinical…