Other investigations Whether any physical investigations should be viewed as ‘routine’ is debatable. However, it is usual to obtain a full blood count and biochemistry including liver and thyroid function and a drug screen (urine or hair analysis). The high yield of cytogenetic abnormalities reported in childhood onset schizophrenia (Kumra et al. 1998d; Nicholson et al. 1999) suggests the value of cytogenetic testing including karyotyping for sex chromosome aneuploidies and fluorescent in situ hybridization (FISH) for chromosome 22q11 deletions (velocardiofacial syndrome). The evidence of progressive structural brain changes (Rapoport et al. 1999) indicates the value of obtaining a baseline and annual follow-up brain MRI scans, although this is not a diagnostic test. C. Hollis
Chris Hollis is Professor of Child and Adolescent Psychiatry and Head of the Developmental Psychiatry Section, University of Nottingham (University Hospital, Queen's Medical Centre, Nottingham NG7 2UH). His research interests include the developmental psychopathology of early psychoses, attention-deficit hyperactivity disorder and developmental language and communication disorders. References

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