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Benefits and Problems of Routine Laboratory Investigations in Adult Psychiatric Admissions

Published online by Cambridge University Press:  02 January 2018

Anthony J. White  and
Brian Barraclough
Anthony J. White*
Affiliation:
Royal South Hants Hospital, Graham Road, Southampton, currently Bristol General Hospital
Brian Barraclough
Affiliation:
University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton S09 4PE
*
∗Bristol General Hospital, Guinea Street, Bristol BS1 6SY
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Abstract

A survey of laboratory investigations in the management of 1007 non-geriatric admissions to a district general hospital adult psychiatric unit showed a wide variation in the number of tests performed, and in the abnormal proportion between test types. Despite a policy of screening on admission, 40% of admissions had no tests. Physical illness attributable to mental illness was common, but rarely serious and usually apparent clinically. Mental illness attributable to physical illness detected by laboratory tests was rare: five cases of thyroid disease in women with affective disorder, and two cases of chest infection with raised white cell count in sustained mania. The findings show that tests are frequently used in circumstances where the result is of no apparent value. Test use might be improved by restricting screening to thyroid function and laboratory urine analysis, each in women. There are particular indications for white cell count in sustained or unexplained relapse of mental illness, and for syphilis serology when disinhibition may have exposed the patient to infection.

Type
Papers
Information
The British Journal of Psychiatry , Volume 155 , Issue 1 , July 1989 , pp. 65 - 72
Copyright
Copyright © The Royal College of Psychiatrists 

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