Evaluation of Methods for Detecting Substance Use Disorder in Persons With Severe Mental Illness

Substance use disorders are frequently undiagnosed in psychiatric settings. One possible reason for this underdiagnosis is the lack of screening procedures designed or validated specifically for psychiatric patients. To evaluate the utility of current detection methods, (a) criterion diagnoses were...

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Bibliographic Details
Published in:Psychology of addictive behaviors 1999-12, Vol.13 (4), p.313-326
Main Authors: Wolford, George L, Rosenberg, Stanley D, Drake, Robert E, Mueser, Kim T, Oxman, Thomas E, Hoffman, Douglas, Vidaver, Robert M, Luckoor, Ravindra, Carrieri, Karen L
Format: Article
Language:English
Subjects:
Biological and medical sciences
Client Characteristics
Demographic Characteristics
Detection
Diagnosis
Drug Abuse
Drug Usage Screening
Evaluation
Female
Hospitalized Patients
Human
Inpatient
Interviews
Male
Medical sciences
Mental Disorders
Mentally ill people
Methodology
Physical Examination
Psychiatric Hospitals
Psychology. Psychoanalysis. Psychiatry
Psychometrics. Diagnostic aid systems
Psychopathology. Psychiatry
Self-Report
Serious Mental Illness
Severely
Substance abuse
Substance Use Disorder
Techniques and methods
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Summary:Substance use disorders are frequently undiagnosed in psychiatric settings. One possible reason for this underdiagnosis is the lack of screening procedures designed or validated specifically for psychiatric patients. To evaluate the utility of current detection methods, (a) criterion diagnoses were established of alcohol use disorder and drug (cannabis or cocaine) use disorder on 320 patients with severe mental illness recently admitted to a psychiatric hospital, using a combination of structured diagnostic interviews and clinician ratings, and (b) the classification accuracy of several substance abuse measures developed for the general population was examined. For this particular sample, demographic variables, clinical variables, medical exams, laboratory tests, and collateral reports did not yield accurate detection. Screens based on self-report were superior to these other approaches but still yielded modest sensitivity. The results suggest that many individuals are classified incorrectly with current techniques.
ISSN:0893-164X
1939-1501
DOI:10.1037/0893-164X.13.4.313