The use of electroencephalography in psychiatry of the medically ill

The psychiatrist considering recommending an EEG should look for acute changes in the history or examination suggestive of an organic cause. If he or she judges that the EEG will help to clarify or confirm the diagnostic impression already formulated, it is worth considering whether adding provocative maneuvers could increase the yield. The authors cannot overemphasize the importance of using the EEG in correlation to further inform old-fashioned clinical detective work already in process, particularly when the EEG could rule out a potential organic contributor to a psychiatric phenotype. For routine screening without an elevated index of suspicion or for thoughtless "fishing expeditions," EEG results will surely disappoint.