Neuropsychological Tests

California Verbal Learning, Wechsler Memory Scale, Controlled Oral Word Fluency, Beck Depression Inventory, Hamilton Depression Rating Scale, Geriatric Depression Rating Scale

Minnesota Multiphasic Personality Inventory-2 (MMPI-2)

Brief psychiatric rating scale; scale for assessment of positive symptoms; scale for assessment of negative symptoms

Frontal Lobe Personality Scale

State train anxiety inventory; anxiety disorders interview schedule

Yale-Brown Obsessive-Compulsive Scale

Luria Complex Motor Tasks (go no go); Wisconsin Card Sorting Test, California Verbal Learning Test; Behavioral Dyscontrol Scale; EXIT; MMPI-2; Frontal Lobe Personality Scale

MMPI-2

CBC, Complete blood count; TFTs, thyroid function tests; VDRL, venereal disease research laboratory test; CSF, cerebrospinal fluid; EEG, electroencephalography; MRI magnetic resonance imaging; CT, computed tomography; ESR, erythrocyte sedimentation rate; HIV, human immunodeficiency virus; EXIT, executive interview.

3-methoxy-4-hydroxyphenylglycol (MHPG), and the thyrotropin-releasing hormone stimulation test. Unfortunately, these studies are not useful in routine clinical practice. A drug screen for amphetamines and other psychoactive medications should be included in the evaluation of patients with appropriate clinical presentations.

Cerebrospinal Fluid. Cerebrospinal fluid must be examined when meningitis (infectious or carcinomatous) and encephalitis are being considered. Cell counts are elevated in patients with infectious or malignant meningitis. There is a polymorphonuclear predominance with bacterial etiologies and a mononuclear predominance with viral, fungal, or malignant causes. There is also an elevated protein and low (bacterial) and normal to low (viral or fungal) glucose levels. Special stains, cultures, and immunofixation studies should be obtained when indicated. A high-volume tap for cytological examination should also be pursued when carcinomatous meningitis is being considered in the presence of a known or suspected malignancy. A single large-volume tap may be negative, and multiple lumbar punctures may be required to effectively document or rule out the possibility of this diagnosis.

Neuropsychological Tests. Neuropsychological testing can be extremely helpful in the diagnosis, prognosis, and treatment of patients with disorders of mood, emotion, and thought and is especially useful for distinguishing "organic" dementia from nonorganic disorders such as the pseudodementia of depression, or malingering. These tests may also help to identify and localize organic syndromes, contribute to the identification of borderline psychotic states, and provide baseline data on the patient's general and specific function. A large number of neuropsychological tests are

available, and the tester must choose the appropriate studies. The Wechsler Adult Intelligence Scale provides three separate IQ scores, and various subtests can provide clues to the presence of disorders of attention and thought (see CMp.t.e.L.2.Z. ). The Minnesota Multiphasic Personality Inventory can produce a general description of the patient's personality characteristics, but it is not useful diagnostically. Other tests that may at times be useful in the evaluation of patients with mood, emotion, and thought disorders include the Bender-Gestalt, Rorschach, thematic aperception, and draw-a-person tests (see ChapteL2.Z ).

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