From the Guidelines
Hit labs should be ordered based on clinical presentation and medical history, rather than as a routine screening for psychiatric patients, as the majority of abnormal results are clinically unimportant or false positives. When evaluating the need for laboratory tests in psychiatric patients, it's essential to consider the findings of studies such as Dolan and Mushlin 1, which showed that less than 1 test in 50 resulted in clinically meaningful results, and false-positive tests were 8 times more common than true-positive tests. The study by Ferguson and Dudleston 1 also suggested that selective rather than routine laboratory ordering is more appropriate, as most abnormal test results were clinically unimportant. Key points to consider when deciding which laboratory tests to order include:
- Clinical presentation and medical history
- Age and risk factors
- Current medications
- Specific concerns or symptoms For example, thyroid function tests (TSH, T3, T4) may be necessary for patients with a history of thyroid disease or symptoms suggestive of thyroid dysfunction, as seen in the study by White and Barraclough 1. However, routine laboratory testing for all psychiatric patients is not recommended, as it can lead to unnecessary costs, false positives, and patient anxiety. Instead, a targeted approach to laboratory testing, based on individual patient needs and clinical presentation, is more appropriate, as suggested by the study by Tintinalli et al 1, which found that ED history and physical examination should have identified 80% of patients requiring acute medical treatment. By taking a thoughtful and targeted approach to laboratory testing, clinicians can provide better care for their patients while minimizing unnecessary tests and costs.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Hit Labs
There is no direct information available on "Hit labs" in the provided studies.
Medically Unexplained Symptoms
- The concept of medically unexplained symptoms (MUS) is discussed in several studies 2, 3, 4.
- MUS are defined as persistent physical symptoms in the absence of identifiable disease 3.
- These symptoms pose a challenge for primary care providers due to complex symptom presentations and strained patient-physician relationships 3.
- A prognosis-based classification of MUS is proposed, which categorizes patients based on their risk of ongoing symptoms, complications, and disability 2.
- Factors such as symptom characteristics, concurrent mental disorders, and demographic data can be used to classify symptoms into different groups 2.
Symptom Understanding
- Symptom understanding is a complex process that involves attribution of meaning and subsequent management 4.
- Theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse analysis can be used to understand symptom perception and management 4.
- Symptoms are situated in culture and context, and trends in modern everyday life can modify symptom understanding continuously 4.