Clinical and nonclinical predictors of test ordering in psychiatric emergency

Objective: This naturalistic prospective study explored the predictors of laboratory test ordering in a psychiatric emergency department. Methods: We used a standardized questionnaire to collect clinical and nonclinical features in 527 consecutive patients. Results: Test ordering was independently predicted by age, spoken language, referral by relatives, eating disorders, and somatic complaints. Having been referred by a general practitioner predicted test ordering only in the absence of a clinical report. Alcohol- and substance-related symptoms predicted test ordering only in patients older than 35 years. Age did not predict test ordering in patients consulting for anxiety or suicidal ideation. Conclusion: Clinicians should be aware of possible biases when assessing the need of laboratory tests in patients presenting with psychiatric complaints. (c) 2008 Elsevier Inc. All rights reserved.