Blood Workup for Schizophrenia

Basic Laboratory Tests

The American Academy of Child and Adolescent Psychiatry recommends complete blood count to assess for underlying infections or hematologic abnormalities in patients with suspected schizophrenia 1
The American Academy of Child and Adolescent Psychiatry recommends comprehensive metabolic panel including serum chemistry studies, calcium, magnesium, and liver function tests for patients with suspected schizophrenia 1
The American Academy of Child and Adolescent Psychiatry recommends thyroid function tests to rule out thyroid disorders that can present with psychiatric symptoms in patients with suspected schizophrenia 1
The American Academy of Child and Adolescent Psychiatry recommends toxicology screen to identify substance-induced psychosis in patients with suspected schizophrenia 1
The American Academy of Child and Adolescent Psychiatry recommends urinalysis to rule out infections or other abnormalities in patients with suspected schizophrenia 1

Human immunodeficiency virus (HIV) testing is recommended if risk factors are present in patients with suspected schizophrenia 1
Chromosomal analysis is recommended if features suggest a developmental syndrome in patients with suspected schizophrenia 1
Erythrocyte sedimentation rate (ESR) is used to assess for inflammatory conditions in patients with suspected schizophrenia 2
Vitamin B12 and folate levels are recommended to rule out deficiencies that can affect cognition in patients with suspected schizophrenia 3
Rapid plasma reagin (RPR) or fluorescent treponemal antibody absorption (FTA-ABS) is used to screen for syphilis in patients with suspected schizophrenia 2
Lyme antibody testing is recommended if clinically indicated in patients with suspected schizophrenia 2

Electroencephalogram (EEG) is recommended if seizure disorder is suspected in patients with suspected schizophrenia 1
Cerebrospinal fluid (CSF) analysis is recommended if CNS infection or inflammatory process is suspected in patients with suspected schizophrenia 1
Autoimmune panels are recommended if autoimmune encephalitis is suspected in patients with suspected schizophrenia 1

Laboratory testing is used to rule out medical causes of psychotic symptoms, not to diagnose schizophrenia itself, according to the American Academy of Child and Adolescent Psychiatry 1
Substance-induced psychosis is common, especially in adolescents, with rates of comorbid substance abuse as high as 50% in some studies, according to the American Academy of Child and Adolescent Psychiatry 1
If psychotic symptoms persist for longer than one week despite documented detoxification, consider primary psychotic disorder rather than substance-induced psychosis, according to the American Academy of Child and Adolescent Psychiatry 1
A comprehensive assessment for schizophrenia should include detailed psychiatric evaluation, physical examination, and consideration of neuroimaging when clinically indicated, according to the American Academy of Child and Adolescent Psychiatry 1