title: Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment.
abstract: Repeat offenders for DUI are routinely mandated to undergo alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment. The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown. As part of a larger study to investigate the impact of sanction conditions on probation outcomes, we screened 233 patients for psychiatric conditions and compared the findings with the psychiatric conditions identified during mandatory treatment by independent treatment providers. Adjusted rates of underdiagnosis were commonly high: 97.2% of bipolar disorder cases, 67.5% of major depression cases, 100% of obsessive-compulsive disorder cases, and 37.3% of drug use disorder cases remained undiagnosed during treatment. Rates of overdiagnosis were low for all disorders, with the exception of drug use disorders. These rates of underdiagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders.
authors.affiliation: Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, NM 87102, USA. gmcmillan@bhrcs.org
authors.forename: Garnett P
authors.initials: GP
authors.lastname: McMillan
authors.forename: David S
authors.initials: DS
authors.lastname: Timken
authors.forename: Jodi
authors.initials: J
authors.lastname: Lapidus
authors.forename: Janet
authors.initials: J
authors.lastname: C'de Baca
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Lapham
authors.forename: Megan
authors.initials: M
authors.lastname: McNeal
mesh_terms: D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D002391:Catchment Area, Health; D003068:Coercion; D015897:Comorbidity; D003937:Diagnosis, Differential; D001330:Electronic Data Processing; D005260:Female; D006801:Humans; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D009922:Oregon / Q000453:epidemiology; D015995:Prevalence; D012008:Recurrence; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation