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Biological assessment of patients with psychiatric symptoms

Biological assessment of patients with psychiatric symptoms. Measurement of biogenic amines and psychotropic drugs—altered levels found in some psychiatric conditions

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Biological assessment of patients with psychiatric symptoms

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  1. Biological assessment of patients with psychiatric symptoms

  2. Measurement of biogenic amines and psychotropic drugs—altered levels found in some psychiatric conditions • Plasma levels of some antipsychotic drugs are measured to evaluate patient compliance & to see if therapeutic levels have been reached • Patients on antimanic drugs carbamazepine or clozapine must be observed for blood abnormalities such as agranulocytosis • Lft for patients treated with carbamazepine and valproic acid • Thyroid levels – lithium .lithium levels to be monitored because of narrow therapeutic range.

  3. Dexamethosone suppression test • In a normal person with normal hypothalamo-adrenal –pituitary axis glucocorticoid suppresses the secretion of cortisol. in major depressive disorder patients have positive dst. ie suppression limited or absent. • Patients with positive dst respond well to treatment. But dst is not specific. nonsuppression is seen in other conditions like schizophrenia, dementia …

  4. Tests of endocrine function • Thyroid function test—screen for hypo or hyperthyroidism which can mimic depression and anxiety respectively. • reduced levels of gonadotrophins--- with schizophrenia • Endocrine disorders like--Addisons disease, cushings disease psychiatric manifestations common.

  5. Neuroimaging & eeg • Neurophysiological tests —assess general intelligence, memory, reasoning, orientation.. • Other tests • Amobarbital sodium interview---intravenous administration of amobarbital sodium (amytal) useful in determining whether organic pathology is responsible for symptomatology in patients who exhibit malingering dissociative disorder or conversion disorder. • Amobarbital can relax patients with these disorders or other disorders involving high levels of anxiety and mute pychotic states so that pt can express themselves better

  6. Sodium lactate admin--- iv administration of sodium lactate can provoke a panic attack • in susceptible patients & can thus help to identify individuals with panic disorder. inhalation of carbon dioxide can also produce same effect.

  7. Galvanic skin response( lie detector test) • Electric resistance of skin (galvanic skin response) varies with patients psychological state • Higher sweat gland activity seen with sympathetic nervous system arousal ( eg. when lying) results in decreased skin resistance • Results in decreased skin resistance

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