title: Comparison of self-reports and biological measures for alcohol, tobacco, and illicit drugs consumption in psychiatric inpatients.
abstract: BACKGROUND
  Asking psychiatric in-patients about their drug consumption is unlikely to yield reliable results, particularly where alcohol and illicit drug use is involved. The main aim of this study was to compare spontaneous self-reports of drug use in hospitalized psychiatric patients to biological measures of same. A secondary aim was to determine which personal factors were associated with the use of tobacco, alcohol, and illicit drugs as indicated by these biological measures.
  
  
  METHODS
  The consumption of substances was investigated using biological measures (urine cotinine, cannabis, opiates, cocaine, amphetamines and barbiturates; blood carbohydrate-deficient transferrin [CDT] and gamma-glutamyl transferase [GGT]) in 486 consecutively admitted psychiatric patients, one day following their hospitalization. Patients' self-reports of alcohol, tobacco and illicit drugs consumption were recorded. Socio-professional and familial data were also recorded.
  
  
  RESULTS
  The results show a low correlation between biological measures and self-reported consumption of alcohol and illicit drugs. Fifty-two percent of the patients under-reported their consumption of illicit drugs (kappa=.47). Patients with schizophrenia and personality disorders were more likely to disclose their illicit drug consumption relative to patients suffering from mood disorders and alcohol dependence. Fifty-six percent of patients underreported alcohol use, as evaluated by CDT (kappa=.2), and 37% underreported when using the CDT+GGT measure as an indicator. Smoking appeared to be reported adequately. In the study we observed a strong negative correlation between cannabis use and age, a strong correlation between tobacco and cannabis use, and correlations between tobacco, cannabis and alcohol consumption.
  
  
  CONCLUSIONS
  This study is the first to compare self-reports and biological measures of alcohol, tobacco and illicit drug uses in a large sample of inpatients suffering from various categories of psychiatric illnesses, allowing for cross-diagnosis comparisons.
authors.affiliation: CH Paul Guiraud, 54, avenue de la République, 94806 Villejuif, France. debeaurepaire@wanadoo.fr
authors.forename: Renaud
authors.initials: R
authors.lastname: de Beaurepaire
authors.forename: Michael
authors.initials: M
authors.lastname: Lukasiewicz
authors.forename: Patrick
authors.initials: P
authors.lastname: Beauverie
authors.forename: Sophie
authors.initials: S
authors.lastname: Castéra
authors.forename: Odile
authors.initials: O
authors.lastname: Dagorne
authors.forename: Renaud
authors.initials: R
authors.lastname: Espaze
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.forename: Patrick
authors.initials: P
authors.lastname: Giroult
authors.forename: Michèle
authors.initials: M
authors.lastname: Houery
authors.forename: Georges
authors.initials: G
authors.lastname: Mahuzier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Matheron
authors.forename: Philippe
authors.initials: P
authors.lastname: Niel
authors.forename: Pierre
authors.initials: P
authors.lastname: Padovani
authors.forename: Nicole
authors.initials: N
authors.lastname: Poisson
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Richier
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rocher
authors.forename: Odile
authors.initials: O
authors.lastname: Ruetsh
authors.forename: Didier
authors.initials: D
authors.lastname: Touzeau
authors.forename: André
authors.initials: A
authors.lastname: Visinoni
authors.forename: Robert
authors.initials: R
authors.lastname: Molimard
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology* / Q000652:urine; D015897:Comorbidity; D003367:Cotinine / Q000652:urine; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000652:urine; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D012559:Schizophrenia / Q000453:epidemiology / Q000652:urine; D012565:Schizophrenic Psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology* / Q000652:urine; D013223:Statistics as Topic; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000652:urine; D014168:Transferrin / Q000031:analogs & derivatives / Q000378:metabolism; D014342:Truth Disclosure; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D013287:Illicit Drugs; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D005723:gamma-Glutamyltransferase; D003367:Cotinine