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Clinical electroencephalography in a psychiatric service
1Department of Psychiatry, University of Dundee, Scotland.
Summary
This audit of electroencephalography (EEG) in psychiatry found 92% of EEGs were clinically valuable. Referrals for EEG were linked to specific symptom clusters, aiding diagnosis in psychiatric patients.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Neurophysiology
Background:
- Electroencephalography (EEG) is a diagnostic tool used in neurology and psychiatry.
- Auditing its use is crucial for optimizing clinical practice and resource allocation.
Purpose of the Study:
- To audit the utilization and clinical value of electroencephalography (EEG) referrals within a psychiatric service.
- To identify clinical features associated with EEG referrals and assess the diagnostic yield.
Main Methods:
- A retrospective audit of EEG referrals from a psychiatric service over one year.
- Comparison of referred patients with matched controls.
- Blind rating of EEGs and assessment of their clinical value.
Main Results:
- EEG referrals constituted 11% of all psychiatric service referrals.
- Abnormal and anomalous EEG results were found in 37% and 19% of cases, respectively.
- Two symptom clusters were associated with EEG referral: organic mental state/CNS signs (usually abnormal EEG) and behavioral changes suggestive of organic processes (usually normal/anomalous EEG).
- 92% of EEGs were deemed clinically valuable (53% positive, 39% negative), with only 8% making no contribution.
Conclusions:
- EEG is a valuable diagnostic tool in psychiatric practice, particularly for patients with suspected organic mental state phenomena or specific behavioral changes.
- The study highlights the importance of appropriate referral criteria to maximize the clinical utility of EEG in psychiatry.