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Laboratory testing is an essential component of the psychiatric evaluation of elderly individuals, who often present with comorbid medical illnesses. The laboratory does not replace the clinician; no test is pathognomonic for a primary psychiatric illness. However, laboratory testing does aid in the evaluation of comorbidities that complicate or contribute to a psychiatric diagnosis. The number and quality of diagnostic tools available have grown significantly. Progress in research and technology, particularly in imaging technology and genetic testing, has advanced rapidly over the past decade. Regardless of the tools available, however, we must balance what we can do with what we should do, as guided by our clinical judgment, relative risk to the patient, and cost expenditure. When all risks are considered, the decision to proceed with a test should be based on the clinical presentation and on how the test results may change a treatment plan.
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