Schizophrenia laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Schizophrenia}} | {{Schizophrenia}} | ||
{{CMG}};{{AE}}{{Vbe}} | {{CMG}}; {{AE}}{{Vbe}}, {{I.D.}} | ||
==Overview== | ==Overview== | ||
An initial assessment includes a comprehensive history and physical examination by a physician. Although there are no biological tests which confirm schizophrenia, tests are carried out to exclude medical illnesses which may rarely present with psychotic schizophrenia-like symptoms. These include blood tests measuring [[Thyroid-stimulating hormone|TSH]] to exclude [[hypothyroidism|hypo-]] or [[hyperthyroidism]], [[Blood tests#Blood chemistry tests|basic electrolytes]] and serum [[calcium]] to rule out a metabolic disturbance, [[Complete blood count|full blood count]] including [[Erythrocyte sedimentation rate|ESR]] to rule out a systemic infection or chronic disease, and [[serology]] to exclude [[syphilis]] or [[HIV]] infection. Drugs of abuse should also be tested for with a [[ | An initial assessment includes a comprehensive [[History and Physical examination|history]] and [[Physical culture|physical]] [[examination]] by a [[physician]]. Although there are no [[biological]] tests which confirm [[schizophrenia]], tests are carried out to exclude [[medical]] illnesses which may rarely present with [[psychotic]] [[schizophrenia]]-like [[symptoms]]. These include [[blood]] tests measuring [[Thyroid-stimulating hormone|TSH]] to exclude [[hypothyroidism|hypo-]] or [[hyperthyroidism]], [[Blood tests#Blood chemistry tests|basic electrolytes]] and serum [[calcium]] to rule out a [[metabolic]] disturbance, [[Complete blood count|full blood count]] including [[Erythrocyte sedimentation rate|ESR]] to rule out a systemic [[infection]] or [[Chronic (medical)|chronic]] [[disease]], and [[serology]] to exclude [[syphilis]] or [[HIV]] infection. Drugs of [[abuse]] should also be tested for with a urine [[drug]] [[Screening (medicine)|screen]], and further [[Diagnostic criteria|diagnostic]] workup is detailed [[Schizophrenia diagnostic studies|here]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
An initial assessment includes a comprehensive history and physical examination by a physician. Although there are no biological tests which confirm schizophrenia, tests are carried out to exclude medical illnesses which may rarely present with psychotic schizophrenia-like symptoms. These include blood tests measuring [[Thyroid-stimulating hormone|TSH]] to exclude [[hypothyroidism|hypo-]] or [[hyperthyroidism]], [[Blood tests#Blood chemistry tests|basic electrolytes]] and serum [[calcium]] to rule out a metabolic disturbance, [[Complete blood count|full blood count]] including [[Erythrocyte sedimentation rate|ESR]] to rule out a systemic infection or chronic disease, and [[serology]] to exclude [[syphilis]] or [[HIV]] infection. Drugs of abuse should also be tested for with a | *An [[Initial-stress-derived noun|initial]] assessment includes a comprehensive [[History and Physical examination|history]] and [[Physical culture|physical]] [[Physical examination|examination]] by a physician.<ref name="pmid26289586">{{cite journal| author=Dougall N, Maayan N, Soares-Weiser K, McDermott LM, McIntosh A| title=Transcranial magnetic stimulation (TMS) for schizophrenia. | journal=Cochrane Database Syst Rev | year= 2015 | volume= | issue= 8 | pages= CD006081 | pmid=26289586 | doi=10.1002/14651858.CD006081.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26289586 }} </ref> | ||
*Although there are no [[biological]] tests which confirm [[schizophrenia]], tests are carried out to exclude medical illnesses which may rarely present with psychotic schizophrenia-like symptoms.<ref name="pmid18291627">{{cite journal| author=Tandon R, Keshavan MS, Nasrallah HA| title=Schizophrenia, "Just the Facts": what we know in 2008 part 1: overview. | journal=Schizophr Res | year= 2008 | volume= 100 | issue= 1-3 | pages= 4-19 | pmid=18291627 | doi=10.1016/j.schres.2008.01.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18291627 }} </ref> | |||
**These include blood tests measuring [[Thyroid-stimulating hormone|TSH]] to exclude [[hypothyroidism|hypo-]] or [[hyperthyroidism]], [[Blood tests#Blood chemistry tests|basic electrolytes]] and serum [[calcium]] to rule out a metabolic disturbance, [[Complete blood count|full blood count]] including [[Erythrocyte sedimentation rate|ESR]] to rule out a systemic infection or chronic disease, and [[serology]] to exclude [[syphilis]] or [[HIV]] infection. | |||
**[[Drugs]] of [[abuse]] should also be tested for with a urine drug screen, and further [[diagnostic]] workup is detailed [[Schzophrenia diagnostic studies|here]].<ref name="pmid20464730">{{cite journal| author=Gorczynski P, Faulkner G| title=Exercise therapy for schizophrenia. | journal=Cochrane Database Syst Rev | year= 2010 | volume= | issue= 5 | pages= CD004412 | pmid=20464730 | doi=10.1002/14651858.CD004412.pub2 | pmc=4164954 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20464730 }} </ref> | |||
Investigations are not generally repeated for relapse unless there is a specific ''medical'' indication. These may include serum [[ | *Investigations are not generally repeated for relapse unless there is a specific ''[[medical]]'' indication.<ref name="pmid22560607">{{cite journal| author=Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G et al.| title=Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. | journal=Lancet | year= 2012 | volume= 379 | issue= 9831 | pages= 2063-71 | pmid=22560607 | doi=10.1016/S0140-6736(12)60239-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22560607 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=22904562 Review in: Evid Based Ment Health. 2012 Nov;15(4):92] </ref> | ||
*These may include [[serum]] [[blood]] [[sugar]] level if [[olanzapine]] has previously been prescribed, [[liver]] function tests if [[chlorpromazine]] or [[CPK]] to exclude [[neuroleptic malignant syndrome]]. | |||
*Assessment and [[Treatment-resistant depression|treatment]] are usually done on an [[outpatient]] basis; admission to an [[inpatient]] facility is considered if there is a [[Risk-benefit analysis|risk]] to self or others. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
Latest revision as of 00:05, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2], Irfan Dotani
Overview
An initial assessment includes a comprehensive history and physical examination by a physician. Although there are no biological tests which confirm schizophrenia, tests are carried out to exclude medical illnesses which may rarely present with psychotic schizophrenia-like symptoms. These include blood tests measuring TSH to exclude hypo- or hyperthyroidism, basic electrolytes and serum calcium to rule out a metabolic disturbance, full blood count including ESR to rule out a systemic infection or chronic disease, and serology to exclude syphilis or HIV infection. Drugs of abuse should also be tested for with a urine drug screen, and further diagnostic workup is detailed here.
Laboratory Findings
- An initial assessment includes a comprehensive history and physical examination by a physician.[1]
- Although there are no biological tests which confirm schizophrenia, tests are carried out to exclude medical illnesses which may rarely present with psychotic schizophrenia-like symptoms.[2]
- These include blood tests measuring TSH to exclude hypo- or hyperthyroidism, basic electrolytes and serum calcium to rule out a metabolic disturbance, full blood count including ESR to rule out a systemic infection or chronic disease, and serology to exclude syphilis or HIV infection.
- Drugs of abuse should also be tested for with a urine drug screen, and further diagnostic workup is detailed here.[3]
- Investigations are not generally repeated for relapse unless there is a specific medical indication.[4]
- These may include serum blood sugar level if olanzapine has previously been prescribed, liver function tests if chlorpromazine or CPK to exclude neuroleptic malignant syndrome.
- Assessment and treatment are usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to self or others.
References
- ↑ Dougall N, Maayan N, Soares-Weiser K, McDermott LM, McIntosh A (2015). "Transcranial magnetic stimulation (TMS) for schizophrenia". Cochrane Database Syst Rev (8): CD006081. doi:10.1002/14651858.CD006081.pub2. PMID 26289586.
- ↑ Tandon R, Keshavan MS, Nasrallah HA (2008). "Schizophrenia, "Just the Facts": what we know in 2008 part 1: overview". Schizophr Res. 100 (1–3): 4–19. doi:10.1016/j.schres.2008.01.022. PMID 18291627.
- ↑ Gorczynski P, Faulkner G (2010). "Exercise therapy for schizophrenia". Cochrane Database Syst Rev (5): CD004412. doi:10.1002/14651858.CD004412.pub2. PMC 4164954. PMID 20464730.
- ↑ Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G; et al. (2012). "Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis". Lancet. 379 (9831): 2063–71. doi:10.1016/S0140-6736(12)60239-6. PMID 22560607. Review in: Evid Based Ment Health. 2012 Nov;15(4):92