Reported prevalence of drug abuse comorbidity in a city-wide emergency rooms system.
Frequency and results of urine toxicology screens in a state-guided system of emergency rooms in a large city were compared with frequency and results of the same tests in the same population at a university-run intensive treatment psychiatric unit. Differences both in prevalence and in results were noted, with the emergency rooms testing significantly less patients than the intensive treatment unit and documenting a significantly lower rate of active substance abuse comorbidity to psychiatric disorders. Possible explanations for these differences are discussed, including clinical, attitudinal, and cost containment factors. These findings have a definite impact on treatment decision making, diagnostic precision, and validity of epidemiologic reports.
Sanguineti
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Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107.
Samuel
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D000328:Adult; D015897:Comorbidity; D003419:Crisis Intervention; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D011619:Psychotropic Drugs; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data*
D013287:Illicit Drugs; D011619:Psychotropic Drugs