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A population study of Norwegian psychiatric patients referred for clinical brain scanning

  • Mona K. Beyer (a1), Turi O. Dalaker (a2), Ole J. Greve (a2), Siv E. Pignatiello (a3) and Ingrid Agartz (a4)...

Patients with psychiatric conditions are often referred for a brain scan during the course of their diagnostic workup.


The aim of our study is to determine frequency and type of organic brain pathology, the relationship to age, gender and psychiatric diagnosis.


We investigated magnetic resonance imaging and computed tomography brain scans from consecutively referred patients over a 10-year period (January 2002-December 2011). The reasons for referral, estimated psychiatric diagnosis, and the pathology discovered for each patient were registered.


A total of 34% of patients demonstrated organic brain pathology, of which 32.8% were considered clinically relevant. This represents a higher frequency of relevant pathology than reported in healthy subjects. Age (P < 0.001) and diagnosis (P = 0.016) were the most important determinants for frequency of pathological findings.


Brain imaging in clinical psychiatry resulted in approximately 30% positive findings mainly associated with increasing pathologies with age, but also with diagnosis.

Declaration of interest

Both T.O.D. and M.K.B. have received honorary from Novartis for scientific lectures about multiple sclerosis. M.K.B. also received honoraria from Biogen for scientific lectures. The other authors have no conflicts of interest.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Mona K. Beyer, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital, PO box 4959 Nydalen, 0424 Oslo. Email:
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1Wahlund, LO, Agartz, I, Saaf, J, Wetterberg, L, Marions, O. MRI in psychiatry: 731 cases. Psychiatry Res 1992; 45(2): 139–40.
2Sommer, IE, de Kort, GA, Meijering, AL, Dazzan, P, Hulshoff Pol, HE, Kahn, RS, et al. How frequent are radiological abnormalities in patients with psychosis? A review of 1379 MRI scans. Schizophr Bull 2013; 39(4): 815–9.
3Gupta, S, Kanamalla, U, Gupta, V. Are incidental findings on brain magnetic resonance images in children merely incidental? J Child Neurol 2010; 25(12): 1511–6.
4Wang, L, Leonards, CO, Sterzer, P, Ebinger, M. White matter lesions and depression: a systematic review and meta-analysis. J Psychiatr Res 2014; 56: 5664.
5Serafini, G, Pompili, M, Borgwardt, S, Houenou, J, Geoffroy, PA, Jardri, R, et al. Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents. Eur Child Adolesc Psychiatry 2014; 23(11): 1023–41.
6Boddaert, N, Zilbovicius, M, Philipe, A, Robel, L, Bourgeois, M, Barthelemy, C, et al. MRI findings in 77 children with non-syndromic autistic disorder. PLoS One 2009; 4(2): e4415.
7Mueller, C, Rufer, M, Moergeli, H, Bridler, R. Brain imaging in psychiatry - a study of 435 psychiatric in-patients at a university clinic. Acta Psychiatr Scand 2006; 114(2): 91100.
8Haijma, SV, Van Haren, N, Cahn, W, Koolschijn, PC, Hulshoff Pol, HE, Kahn, RS. Brain volumes in schizophrenia: a meta-analysis in over 18 000 subjects. Schizophr Bull 2013; 39(5): 1129–38.
9Falkai, P. Differential diagnosis in acute psychotic episode. Int Clin Psychopharmacol 1996; 11(Suppl 2): 13–7.
10World Health Organization. Implementation of the International Statistical Classification of Diseases and related health problems, Tenth Revision (ICD-10). Epidemiol Bull 1997; 18(1): 14.
11Kim, BS, Illes, J, Kaplan, RT, Reiss, A, Atlas, SW. Incidental findings on pediatric MR images of the brain. AJNR Am J Neuroradiol 2002; 23(10): 1674–7.
12Osborn, AG. Osborn's BRAIN, Imaging, Pathology, and Anatomy. Amirsys, Inc, 2012.
13George, D, Mallery, P. SPSS for Windows Step by Step: A Simple Guide and Reference. 11.0 update. Allyn & Bacon, 2003.
14Lubman, DI, Velakoulis, D, McGorry, PD, Smith, DJ, Brewer, W, Stuart, G, et al. Incidental radiological findings on brain magnetic resonance imaging in first-episode psychosis and chronic schizophrenia. Acta Psychiatr Scand 2002; 106(5): 331–6.
15Gur, RE, Kaltman, D, Melhem, ER, Ruparel, K, Prabhakaran, K, Riley, M, et al. Incidental findings in youths volunteering for brain MRI research. AJNR Am J Neuroradiol 2013; 34(10): 2021–5.
16Illes, J, Rosen, A, Huang, L, Goldstein, R, Raffin, T, Swan, G, et al. Ethical consideration of incidental findings on adult brain MRI in research. Neurology 2004; 62(6): 888–90.
17Vernooij, MW, Ikram, MA, Tanghe, HL, Vincent, AJ, Hofman, A, Krestin, GP, et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007; 357(18): 1821–8.
18van Lutterveld, R, van den Heuvel, MP, Diederen, KM, de Weijer, AD, Begemann, MJ, Brouwer, RM, et al. Cortical thickness in individuals with non-clinical and clinical psychotic symptoms. Brain 2014; 137(Pt 10): 2664–9.
19Ribeiz, SR, Duran, F, Oliveira, MC, Bezerra, D, Castro, CC, Steffens, DC, et al. Structural brain changes as biomarkers and outcome predictors in patients with late-life depression: a cross-sectional and prospective study. PLoS One 2013; 8(11): e80049.
20Mackin, RS, Tosun, D, Mueller, SG, Lee, JY, Insel, P, Schuff, N, et al. Patterns of reduced cortical thickness in late-life depression and relationship to psychotherapeutic response. Am J Geriatr Psychiatry 2013; 21(8): 794802.
21Tham, MW, Woon, PS, Sum, MY, Lee, TS, Sim, K. White matter abnormalities in major depression: evidence from post-mortem, neuroimaging and genetic studies. J Affect Disord 2011; 132(1–2): 2636.
22Kooistra, M, Geerlings, MI, van der Graaf, Y, Mali, WP, Vincken, KL, Kappelle, LJ, et al. Vascular brain lesions, brain atrophy, and cognitive decline. The Second Manifestations of ARTerial disease--Magnetic Resonance (SMART-MR) study. Neurobiol Aging 2014; 35(1): 3541.
23Zanetti, MV, Schaufelberger, MS, de Castro, CC, Menezes, PR, Scazufca, M, McGuire, PK, et al. White-matter hyperintensities in first-episode psychosis. Br J Psychiatry 2008; 193(1): 2530.
24Pridmore, S, Bowe, G. Neuroimaging in the field of psychoses. Malays J Med Sci 2011; 18(1): 611.
25Baquero, GA, Molero, P, Pla, J, Ortuno, F. A schizophrenia-like psychotic disorder secondary to an arachnoid cyst remitted with neurosurgical treatment of the cyst. The open neuroimaging journal 2014; 8: 14.
26Biswas, PS, Sen, D, Chaudhary, S. Middle cranial fossa arachnoid cyst presenting with obsessive compulsive behaviour associated with psychosis - two cases. African journal of psychiatry 2012; 15(1): 5960.
27Kalapatapu, RK. Aripiprazole treatment of psychosis in a child with posterior fossa retrocerebellar arachnoid cyst. Journal of child and adolescent psychopharmacology 2009; 19(3): 321–5.
28Kuloglu, M, Caykoylu, A, Yilmaz, E, Ekinci, O. A left temporal lobe arachnoid cyst in a patient with schizophrenia-like psychosis: a case report. Progress in neuro-psychopharmacology & biological psychiatry 2008; 32(5): 1353–4.
29Mironov, A, John, S, Auerbach, J, Jamaleddine, G. Acute onset of psychosis in a patient with a left temporal lobe arachnoid cyst. Case reports in medicine 2014; 2014: 204025.
30Arnone, D, Cavanagh, J, Gerber, D, Lawrie, SM, Ebmeier, KP, McIntosh, AM. Magnetic resonance imaging studies in bipolar disorder and schizophrenia: meta-analysis. Br J Psychiatry 2009; 195(3): 194201.
31Quigley, SJ, Scanlon, C, Kilmartin, L, Emsell, L, Langan, C, Hallahan, B, et al. Volume and shape analysis of subcortical brain structures and ventricles in euthymic bipolar I disorder. Psychiatry Res 2015; 233(3): 324–30.
32Selvaraj, S, Arnone, D, Job, D, Stanfield, A, Farrow, TF, Nugent, AC, et al. Grey matter differences in bipolar disorder: a meta-analysis of voxel-based morphometry studies. Bipolar Disord 2012; 14(2): 135–45.
33Brix, MK, Westman, E, Simmons, A, Ringstad, GA, Eide, PK, Wagner-Larsen, K, et al. The Evans' Index revisited: New cut-off levels for use in radiological assessment of ventricular enlargement in the elderly. European journal of radiology 2017; 95: 2832.
34Haberg, AK, Hammer, TA, Kvistad, KA, Rydland, J, Muller, TB, Eikenes, L, et al. Incidental intracranial findings and their clinical impact; the HUNT MRI study in a general population of 1006 participants between 50-66 years. PLoS One 2016; 11(3): e0151080.
35Pendlebury, ST, Rothwell, PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol 2009; 8(11): 1006–18.
36Firbank, MJ, Teodorczuk, A, van der Flier, WM, Gouw, AA, Wallin, A, Erkinjuntti, T, et al. Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study. Br J Psychiatry 2012; 201(1): 40–5.
37Abraham, HM, Wolfson, L, Moscufo, N, Guttmann, CR, Kaplan, RF, White, WB. Cardiovascular risk factors and small vessel disease of the brain: blood pressure, white matter lesions, and functional decline in older persons. J Cereb Blood Flow Metab 2016; 36(1): 132–42.
38Morris, Z, Whiteley, WN, Longstreth, WT Jr, Weber, F, Lee, YC, Tsushima, Y, et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2009; 339: b3016.
39Katzman, GL, Dagher, AP, Patronas, NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999; 282(1): 36–9.
40Togersen, K, Bjerke, E, Gjelstad, K, Ruud, T. Compulsory hospitalisation in mental health care in Ostfold in 2000 and 2010. Tidsskr Nor Laegeforen 2015; 135(1): 31–4.
41Solheim, O, Torsteinsen, M, Johannesen, TB, Jakola, AS. Effects of cerebral magnetic resonance imaging in outpatients on observed incidence of intracranial tumors and patient survival: a national observational study. J Neurosurg 2014; 120(4): 827–32.
42Norwegian Directorate of Health. Utredning, behandling og oppfølging av personer med psykoselidelser. 182. Helsedirektoratet/The Norwegian Directorate of Health, 2013.
43National Institute for Health and Care Excellence. Structural Neuroimaging in First-Episode Psychosis. National Institute for Health and Care Excellence, 2008 (
44de Hert, M, Correll, CU, Bobes, J, Cetkovich-Bakmas, M, Cohen, D, Asai, I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 2011; 10(1): 5277.
45Dieset, I, Andreassen, OA, Haukvik, UK. Somatic comorbidity in schizophrenia: some possible biological mechanisms across the life span. Schizophr Bull 2016; 42(6): 1316–19.
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A population study of Norwegian psychiatric patients referred for clinical brain scanning

  • Mona K. Beyer (a1), Turi O. Dalaker (a2), Ole J. Greve (a2), Siv E. Pignatiello (a3) and Ingrid Agartz (a4)...
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