Phobic Disorders Workup

Updated: Aug 01, 2018
  • Author: Adrian Preda, MD; Chief Editor: David Bienenfeld, MD  more...
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Workup

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