Investigations in Psychiatry


Psychiatrist depend more on the clinical examination and the patient's signs and symptoms to make a diagnosis. No laboratory tests in psychiatry can confirm or rule out diagnosis such as schizophrenia, bipolar disorder, In clinical psychiatry laboratow tests can help rule out potential underlying organic causes of psychiatric symptoms.
The use of diagnostic tests in detecting physical illness in psychiatric patients:
Physical disorders are quite common, and also these may cause or exacerbate psychiatric symptomatology. It has been observed that many psychiatric patients with concomitant medical disorders have high mortality rate.
A. Screening tests used include:
1.       Complete blood count (including peripheral smear and ESR)
2.       Blood chemistry (electrolytes including calcium, phosphorous, glucose, blood urea, creatinine, hepatic functions)
3.       Urine analysis
4.       ECG
5.       X-ray skull and chest
6.       Screening test for syphilis
7.       Thyroid function test (T3 resin uptake, T4 , TSH)
8.       Vitamin B 12 and folate levels
B. Supplementary Tests
·         When the commonly used tests are negative and an organic cause is suspected-
·         CT scan
·         CSF examination
·         Stool test for occult blood
·         Urine and serum osmolality
·         Antinuclear antibodies
·         Drug screen (eg. Thin layer chromatography, gas chromatography) Serum and urine copper levels
·         HIV testing
·         MRI
·         Blood or breath alcohol level
·         Heavy metal screening Blood levels of medications
·         Serum ceruloplsmin
C. Special investigations in psychiatry:
1.  Electroencephalography (EEG):
It is recording of the electrical activity of the brain, It records brain waves which are continuously varying in frequency, form and amplitude.
2. Polysomnography (sleep studies):
EEG activity is recorded during sleep and it is usually performed at night. Several disorders associated with psychiatric symptoms like sleep apnoea, narcolepsy, hypersomnia, seizure disorders, headaches, sexual dysfunction; insomnia can be evaluated by the sleep laboratory  
3. CT scan:



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Investigations in Psychiatry
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