Mental Health Investigations
Bedside
Fluids
Machines
Physiological
Urine
Drug screen
ECG
Long QTc - antipsychotics
BM
Depression - anxiety, irritability, low mood can be caused by hypoglycaemia
Arrhythmias
UTI (delirium)
MSU microscopy, culture and sensitivities (infection as a cause of delirium)
Basic observations
Communication
Collateral history
Haemodynamic stability
Hypovolaemia
Elevated BP in vascular dementia
Cognitive assessment
ACE III
EEG
Epilepsy (psychosis)
Mood assessment
Patient Health Questionnaire (PHQ-9)
DSM-IV criteria (NICE)
Hospital Anxiety and Depression (HAD) scale
ABG
Metabolic abnormalities
Self-harm
Eating disorders
MMSE
Bloods
Other
Blood glucose
Hypoglycaemia is a common cause of delirium, potentially life-threatening
HbA1c
Antipsychotics can lead to diabetes
Hypoglycaemia can cause anxiety/ irritability/ low mood
Hypoglycaemia is a risk factor for vascular dementia
B12/ folate
Macrocytic anaemias, can compound confusion
Low levels mimic dementia
Circulatory
Lipid screen
Risk factor for vascular dementia
Side effects of antipsychotics
CRP
Acute inflammation
LFT
Liver failure/ malnutrition/ alcohol use can all cause confusion/ delirium
Baseline drug use and monitoring
AST:ALT of 2:1 in alcoholism
FBC
Anaemia, raised MCV in alcoholism, infection
U/E
Monitor Lithium specifically in Bipolar disorder
Baseline drug use and monitoring
Deranged electrolytes can cause confusion/ delirium
INR
Warfarin patients - concern about intracranial/ other bleeding
Ions
Bone Profile
Calcium
Hypocalcaemia
Hypercalcaemia
Hypercalcaemic can cause confusion/ delirium
Hormones
TFT
Hypothyroidism as a side effect of Lithium
Hypothyroidism - differential in depression
Hyperthyroidism - differential in anxiety
psychic moans can mimic depression
Increased risk of falls with osteoporosis in the elderly
Imaging
MRI
CXR
CT
As a cause of delirium
Infection causing delirium
Vascular dementia/ SOL
Vascular dementia/ SOL