Tests in psychiatry.

Abstract

OBJECTIVE: This essay examines the proposition that clinical psychiatrists should make more use of the ancillary tests available to them. It argues that many of the tests are of doubtful validity and are more concerned with sorting patients into categories which are both impermanent and insubstantial than with clinical usefulness. METHOD: Consideration is given to the way in which many psychiatrists use those tests of mental status which are available to them, often showing little awareness of the scoring procedures, norms and limitations of the tests being used. Many of the questionnaires available restrict the field of enquiry to achieve reliability at the cost of validity. Careful examination of some commonly used measures has shown that they do nothing to improve diagnostic accuracy and can be misleading. Simple direct questions can be more useful and more valid. RESULTS AND CONCLUSIONS: The ancillary tests available to psychiatrists do little to assist them and the important problems of clinical management. In general, they are more concerned with attaching labels to patients than throwing light on the nature of their disorders and how they may be managed.