Chapter 5.Laboratory Testing and Neuroimaging Studies in Psychiatry

Excellence in psychiatric care can be achieved only when all components of the patient evaluation—including the history, review of systems, functional assessment, physical and mental status examinations, and laboratory evaluation—are brought to bear on diagnosis and management. A good working knowledge of general medicine equips the clinician to make predictions as to the likelihood that particular laboratory tests will be helpful and thus to use these resources judiciously. These predictions take into account not only the patient’s signs and symptoms but also other pertinent variables such as patient demographics and the setting in which the patient is seen. For example, a head computed tomography (CT) scan in an elderly patient with a suspected stroke seen in the emergency department would be useful whether positive or negative for blood, whereas the same test in a patient attending a clinic for mild neurocognitive disorders might not be as informative as an alternative such as a brain magnetic resonance imaging (MRI) scan.