Clinical Use of Laboratory Tests, Brain Imaging, and Biomarkers

Although the interview and mental status examination are the primary tools used to make diagnoses in psychiatry, laboratory testing and neuroimaging are essential both to the work-up of patients presenting with neuropsychiatric complaints and to the monitoring of psychotropic medications. Increasing recognition of medical comorbidities in patients with chronic psychiatric illnesses and the adverse health effects of many psychotropic medications makes it imperative that clinicians be able to utilize laboratory and other diagnostic testing when appropriate. Currently, the availability of laboratory and imaging studies that can meaningfully help clinical psychiatrists with early identification, management, and prevention of psychiatric disorders is very limited. However, there is widely held hope that ongoing research into genetic and biological markers for major psychiatric disorders will someday result in an increased arsenal of valuable tools for the clinical psychiatrist. This chapter reviews the role for currently available laboratory tests, imaging, and other assessment tools in the work-up and management of patients presenting with neuropsychiatric complaints and explores the state of current research into potentially useful biological markers for psychiatric disorders.