Schizophrenia laboratory findings

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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

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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

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* 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

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1. ↑ 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.CS1 maint: Multiple names: authors list (link)
2. ↑ 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.CS1 maint: Multiple names: authors list (link)
3. ↑ 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.
4. ↑ 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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)  Review in: Evid Based Ment Health. 2012 Nov;15(4):92

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