Table 3. Tests That May Be Indicated as Part of a Psychiatric Evaluation
Basic lab tests (e.g., complete blood count; blood
chemistries, including lipid profile, B12,
Used to screen for general medical conditions or provide baseline
measures prior to treatment. Recommended frequency of screening
may vary with health status and with specific ongoing treatments
(e.g., second-generation antipsychotics, lithium).
Used to monitor therapeutic levels of medications.
Some psychiatric conditions and treatments may entail
risks to a pregnant woman or her fetus.
Fasting blood glucose or hemoglobin A1c
Used to diagnose diabetes or help determine risk. Patients prescribed
second-generation antipsychotics may be at increased risk of developing
Lyme serology, syphilis serology, HIV test
May assist in evaluation of cognitive and behavioral changes.
Individuals with behavioral problems such as impulsivity or drug
use may be at increased risk for HIV infection.
Thyroid function tests
May be important for patients with suspected mood disorder, anxiety
disorder, or dementia. Used to monitor lithium effects.
Toxicology screen, blood alcohol level
Used to screen for substance use or abuse. Individuals
with a mental disorder are at increased risk for substance abuse.
Used to diagnose central nervous system infection (e.g., meningitis,
herpes, toxoplasmosis, syphilis, Lyme disease). May be important
for differential diagnosis of delirium.
Used to assess effects of medications that may influence cardiac
conduction (e.g., tricyclic antidepressants, some antipsychotics).
May also be indicated depending on age and health status.
Chest X ray
Used to diagnose cardiopulmonary disorders (e.g., pneumonia,
tuberculosis) that may contribute to delirium. May also be part
of a pre-ECT evaluation depending on age and health status.
Structural (e.g., CT, MRI) and functional
(e.g., PET, SPECT, EEG, fMRI) studies
may indicate regional brain abnormalities related to a psychiatric
illness and its management.
Used to diagnose sleep disorders, including sleep apnea. May
be important for differential diagnosis of depression, psychosis,
or other cognitive or behavioral changes.
May be requested when cognitive deficits are suspected
or there is need to grade for severity or progression of symptoms
over time. May also be helpful in establishing a diagnosis (e.g.,
dementia, mental retardation) or in delineating specific deficits
that affect thought processes, treatment, or vocational planning.