Advances in electrophysiology in the diagnosis of behavioral disorders

Diagnosis in psychiatry remains largely subjective. Developing biological observations in psychiatric disorders into laboratory-based diagnostic tests can significantly impact diagnosis and management of these disorders. Diagnostic electrophysiological techniques are non-invasive and relatively inexpensive.

In this review, the authors propose that enough knowledge has accumulated to allow the establishment of psychiatry-based clinical electrophysiology laboratories (PCELs). A brief summary of established clinical indications for electrophysiology tests, summary of highly promising technologies and a presentation of a proposed four-step approach to facilitate the translation of promising biological observations into diagnostic tests are provided. The reader should develop an appreciation of the current status of the clinical applications of psychiatric electrophysiology. The authors propose to capitalize on the widely accepted indication to rule out medical causes of psychiatric symptoms (e.g., epileptic activity) to begin developing PCELs as the equipment and skills necessary are basic to the entire discipline. The potential impact of the growing knowledge on the practice of psychiatry is explored to update clinicians and administrators as they develop laboratory and service plans.

Psychiatric electrophysiology currently plays a limited role in the diagnosis and management in psychiatry. This status is not supported by the existing literature. The underutilization of electrophysiological tests in psychiatry is propagated by the fact that the laboratories providing the service are not managed by psychiatrists. The authors propose that the first steps are to establish such laboratories and train psychiatrists to competently provide the service.