title: Use of case manager ratings and weekly urine toxicology tests among outpatients with dual diagnoses.
abstract: Use of drugs and alcohol by 43 predominantly male outpatients who had severe mental illness and a comorbid substance use disorder were assessed weekly through the ratings of experienced dual disorder case managers and through blinded research urine toxicology tests. The percentage of weeks in which drugs or alcohol were used was calculated on the basis of one or both assessments. The case managers often missed drug use over the weekends, which was detected by the urine toxicology tests. Agreement between the two methods varied widely, even when the ratings were made by highly experienced case managers. These findings have implications for monitoring patients with dual diagnoses and provide insight into the accuracy of case manager ratings.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Mental Health Services, Seattle 98104, USA. rries@hmhs.hmc.washington.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Ries
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Dyck
authors.forename: Robert
authors.initials: R
authors.lastname: Short
authors.forename: Debra
authors.initials: D
authors.lastname: Srebnik
authors.forename: Mark
authors.initials: M
authors.lastname: Snowden
authors.forename: Katherine Anne
authors.initials: KA
authors.lastname: Comtois
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000534:rehabilitation* / Q000652:urine; D000553:Ambulatory Care; D019090:Case Management; D003865:Major Depressive Disorder / Q000534:rehabilitation* / Q000652:urine; D003937:Diagnosis, Differential; D017831:Diagnosis, Dual (Psychiatry); D000431:Ethanol / Q000652:urine; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000534:rehabilitation* / Q000652:urine; D012559:Schizophrenia / Q000534:rehabilitation* / Q000652:urine; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation* / Q000652:urine
chemical_list: D013287:Illicit Drugs; D000431:Ethanol