A man who feels his coworkers are out to get him denies hallucinations. What should be ordered to aid in his evaluation?

When evaluating a patient who presents with paranoia and a belief that coworkers are out to get him, it is essential to consider the potential for underlying medical conditions that could contribute to psychiatric symptoms. In this case, ordering a thyroid-stimulating hormone (TSH) test is a logical step because thyroid disorders, particularly hyperthyroidism or hypothyroidism, can manifest with psychiatric symptoms such as anxiety, paranoia, or mood changes.

Assessing thyroid function is an important part of the evaluation process, as abnormal levels of thyroid hormone can lead to significant alterations in mental status. For instance, hyperthyroidism may present with symptoms such as irritability, restlessness, and paranoia, while hypothyroidism can result in depressive symptoms and cognitive impairment.

The other options, such as computed tomography of the head or lumbar puncture, are generally reserved for more specific concerns regarding structural abnormalities or infections affecting the central nervous system. An electroencephalogram is typically utilized for seizure activity evaluation rather than for assessing basic psychiatric symptoms. Therefore, a TSH test is appropriate and effective for ruling out or confirming any thyroid-related causes of the man's symptoms.