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Phobic Disorders Workup

  • Author: Adrian Preda, MD; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK)  more...
 
Updated: Jul 30, 2014
 

Approach Considerations

Any patient who presents with a new complaint of physical symptoms suggesting an anxiety disorder should undergo a basic laboratory workup to help rule out medical conditions that might present with anxietylike symptoms, such as those in the differential diagnosis (see Differentials).

To rule out anxiety secondary to medical conditions, the following laboratory tests may be helpful:

  • Thyroid function tests - Hypothyroidism or hyperthyroidism
  • Fasting glucose - Hypoglycemia
  • Calcium - Hyperparathyroidism
  • 24-hour urine for 5-hydroxyindoleacetic acid (5-HIAA) - Pheochromocytoma
  • Drug screen - Substance-induced anxiety

The following studies may also be considered:

  • Electrocardiography (ECG) and cardiac enzyme tests - Myocardial infarction or arrhythmia
  • Electroencephalography (EEG) - Seizure disorders (these conditions may mimic anxiety)

At present, provocation studies with carbon dioxide, sodium lactate, or yohimbine are reserved for research purposes.

Imaging studies are limited to presentations where medical illness, such as a seizure disorder, is suspected.

  • Computed tomography (CT) of the head - Suspected intracranial abnormality
  • Magnetic resonance imaging (MRI) - Intracranial abnormality
  • Echocardiography - Mitral valve prolapse
  • Positron emission tomography (PET) - This is currently reserved for research purposes
 
 
Contributor Information and Disclosures
Author

Adrian Preda, MD Professor of Clinical Psychiatry and Human Behavior, Director of Residency Program in Psychiatry, Vice-Chair, Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine

Adrian Preda, MD is a member of the following medical societies: American Association for the Advancement of Science, American Psychiatric Association, International College of Neuropsychopharmacology, International Congress of Schizophrenia Research, Schizophrenia International Research Society, Society of Biological Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych(UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of the Health Sciences; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych(UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Neuropsychiatric Association, American Society of Clinical Psychopharmacology, Royal College of Psychiatrists, American Association for Geriatric Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Acknowledgements

Mohammed A Memon, MD Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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