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Clinical utility of magnetic resonance imaging in first-episode psychosis

  • Irina Falkenberg (a1), Stefania Benetti (a2), Marie Raffin (a3), Phillipe Wuyts (a4), William Pettersson-Yeo (a2), Paola Dazzan (a2), Kevin D. Morgan (a5), Robin M. Murray (a2), Tiago Reis Marques (a2), Anthony S. David (a2), Jozef Jarosz (a6), Andrew Simmons (a7), Steve Williams (a7) and Philip McGuire (a2)...

There is no consensus as to whether magnetic resonance imaging (MRI) should be used as part of the initial clinical evaluation of patients with first-episode psychosis (FEP).


(a) To assess the logistical feasibility of routine MRI; (b) to define the clinical significance of radiological abnormalities in patients with FEP.


Radiological reports from MRI scans of two FEP samples were reviewed; one comprised 108 patients and 98 healthy controls recruited to a research study and the other comprised 241 patients scanned at initial clinical presentation plus 66 healthy controls.


In the great majority of patients, MRI was logistically feasible. Radiological abnormalities were reported in 6% of the research sample and in 15% of the clinical sample (odds ratio (OR) = 3.1, 95% CI 1.26–7.57, χ2(1) = 6.63, P = 0.01). None of the findings necessitated a change in clinical management.


Rates of neuroradiological abnormalities in FEP are likely to be underestimated in research samples that often exclude patients with organic abnormalities. However, the majority of findings do not require intervention.

Corresponding author
Irina Falkenberg, Department of Psychiatry und Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany. Email:
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See editorial, pp. 192–193, this issue.

This work was supported by the G. A. Lienert Foundation, Adolf-Schmidtmann-Foundation, FAZIT-Foundation and German Academic Exchange Service (to I.F.). This work was funded by the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust, and the Institute of Psychiatry, Psychology and Neuroscience, King's College London.

Declaration of interest


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Clinical utility of magnetic resonance imaging in first-episode psychosis

  • Irina Falkenberg (a1), Stefania Benetti (a2), Marie Raffin (a3), Phillipe Wuyts (a4), William Pettersson-Yeo (a2), Paola Dazzan (a2), Kevin D. Morgan (a5), Robin M. Murray (a2), Tiago Reis Marques (a2), Anthony S. David (a2), Jozef Jarosz (a6), Andrew Simmons (a7), Steve Williams (a7) and Philip McGuire (a2)...
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