Discrepancies between patient report, clinical assessment, and urine analysis in psychiatric patients during inpatient admission.
Self-report and clinical assessment of substance use were compared with urine analysis results in 56 male patients consecutively admitted for inpatient psychiatric treatment. All subjects received DSM-III-R Axis I diagnosis and were classified into diagnostic groups. Urine samples were tested for cocaine, marijuana, opiates, phencyclidine (PCP), amphetamines, and barbiturates. Thirty-five of the 56 patients (62%) produced urine samples that were positive for at least 1 substance of abuse. Of this group, 15 patients (27% of total sample) denied substance use during the week prior to admission. In addition, the admitting physician did not identify intoxication in 23 of the 35 patients (66%) with positive urines. The admitting physician's assessment matched the patient's answers regarding recent substance use in 79 percent of the patients. This association was especially apparent with the 26 patients who denied recent substance use, all but one of whom received a drug-negative assessment from the admitting physician.
West Los Angeles Veterans Administration Medical Center, Brentwood Division, CA 90073.
J N
JN
Wilkins
A L
AL
Shaner
M
M
Patterson
D
D
Setoda
D
D
Gorelick
D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000652:urine*; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000652:urine*