title: Detection of substance use disorders among psychiatric inpatients.
abstract: This study examines the utility of the Addiction Severity Index (ASI) for detecting psychoactive substance use disorders (PSUDs) among psychiatric inpatients. Four hundred thirty-five inpatients at two inner-city psychiatric hospitals completed the ASI and the Structured Clinical Interview for DSM-III-R (SCID). Receiver operating characteristic (ROC) analysis assessed the optimal threshold ASI alcohol and drug composite scores to detect DSM-III-R PSUDs. The correlations of both the ASI alcohol and drug composite scores with their corresponding DSM-III-R PSUD categories were significant (p<.0001). However, the ROC analysis revealed that the ASI misses approximately 20% of SCID-positive PSUD cases. Specificity of the ASI, on the other hand, is quite good (95% to 98%), and optimal ASI threshold scores to rule out a PSUD among these patients are identified. The results also support the sensitivity of these patients to the toxic effects of illicit substance use.
authors.affiliation: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, 21201, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Lehman
authors.forename: C P
authors.initials: CP
authors.lastname: Myers
authors.forename: L B
authors.initials: LB
authors.lastname: Dixon
authors.forename: J L
authors.initials: JL
authors.lastname: Johnson
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales / Q000592:standards* / Q000706:statistics & numerical data; D011594:Psychometrics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D014505:Urban Population