The Centre for Addiction and Mental Health Concurrent Disorders Screener

• Published in: Canadian journal of psychiatry 2004-12, Vol.49 (12), p.843-850
• Main Authors: Negrete, Juan C, Collins, Jane, Turner, Nigel E, Skinner, Wayne
• Format: Article
• Language: English
• Subjects: Addictions; Adult; Biological and medical sciences; Diagnosis, Computer-Assisted; Female; Health services; Humans; Male; Mass Screening - methods; Medical sciences; Mental disorders; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - rehabilitation; Mental Health Services; Personality disorders; Primary care; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Reproducibility of Results; Schizophrenia; Sensitivity and Specificity; Substance abuse treatment; Substance Abuse Treatment Centers; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - rehabilitation; Surveys and Questionnaires; Techniques and methods
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674370404901208

Objectives: To review the characteristics of psychiatric screening tools currently available in addiction treatment services for rapid assessment of comorbid pathology and to introduce the Centre for Addictions and Mental Health Concurrent Disorders Screener (CAMH-CDS), a computer-administered questionnaire that screens for the occurrence of 11 Axis I disorders plus all substance use disorders, as well as for a history of conduct disorder. Methods: We describe the structure, contents, and application of the CAMH-CDS. We undertook a sensitivity and specificity trial involving 171 subjects, a test–retest reliability study with 301 participants, and an open-label concordance study with 656 respondents. All subjects were regular clients of a major addiction treatment facility. Results: The CAMH-CDS was easily and effectively used by addiction counsellors with limited or no mental health training. It has a low rate of false-negative responses, and it yields excellent test–retest reliability figures. It is highly sensitive to identifying persons with psychiatric disturbances; however, its ability to discriminate among specific disorders appears to be more limited. Conclusions: The CAMH-CDS can be reliably used to rule out the presence of psychiatric comorbidity in addiction service populations. As with other psychiatric screening instruments, its sensitivity values are stronger than its specificity values. The use of nonstructured clinical evaluations as the gold standard for diagnosis and a likely variance in the patients' symptom reports between the 2 examinations may have contributed to the latter finding.