Zametkin A J, Ernst M, Silver R
National Institute of Mental Health, NIH, Bethesda, MD 20892, USA.
J Am Acad Child Adolesc Psychiatry. 1998 May;37(5):464-72. doi: 10.1097/00004583-199805000-00007.
To review in a critical fashion the literature of the past decade covering diagnostic and laboratory testing in the field of child and adolescent psychiatry.
A computerized search of articles published during the past decade was made, and selected articles are presented. Because of the paucity of articles specifically relating to minors, selected articles from adult psychiatry are cited.
With a few notable exceptions, few controlled studies on the specificity and sensitivity of any laboratory test for any specific disorder of behavior presenting in children have been conducted in children and adolescents. A high index of suspicion will remain the clinician's best ally in utilizing laboratory measures in the assessment of psychopathology. Nonetheless, studies have appeared that will guide the clinician as to what tests are not clinically useful.
Indications and the lack of indications for specific laboratory studies are an integral part of the knowledge base that child psychiatrists must have. Much more empirical data will need to be collected prospectively to inform the field and to move the judicious use of the laboratory from an art to a science.
以批判性的方式回顾过去十年中有关儿童和青少年精神病学领域诊断和实验室检测的文献。
对过去十年发表的文章进行计算机检索，并呈现所选文章。由于专门针对未成年人的文章较少，因此引用了成人精神病学的所选文章。
除了少数显著的例外情况，针对儿童和青少年中出现的任何特定行为障碍的任何实验室检测的特异性和敏感性，几乎没有进行过对照研究。在利用实验室检测评估精神病理学方面，高度的怀疑指数仍将是临床医生最好的帮手。尽管如此，已有研究出现，将指导临床医生了解哪些检测在临床上没有用处。
特定实验室研究的适应症和缺乏适应症是儿童精神科医生必须具备的知识库的一个组成部分。需要前瞻性地收集更多的实证数据，以为该领域提供信息，并将实验室检测的明智使用从一门艺术转变为一门科学。
