Using brief self-reports and clinician scales to screen for substance use disorders in psychotic patients.
OBJECTIVE
The aims of this study were to examine evidence for the concurrent validity of two self-report measures and two staff-report measures measuring alcohol and drug problems in seriously mentally ill people and to examine if psychotic patients under-report their alcohol and drug problems in an early intervention clinic.


METHODS
This is a cross-sectional study of 48 patients (26 inpatients and 22 outpatients) from an early intervention clinic for psychosis. To examine the sensitivity and specificity, we compared both the staff-report measures Clinical Alcohol Use Scale (AUS) and Clinical Drug Use Scale (DUS) and the self-report measures Short Michigan Alcohol Screening Test (SMAST-13) and Drug Abuse Screening Test (DAST-20), with the current ICD-10 diagnostic criteria as the gold-standard for alcohol and drug problems. To examine whether the patients under-report their alcohol and drug problems, we also compared the self-report measures SMAST-13 and DAST-20 with the staff-report measures AUS and DUS and ICD-10 consensus substance abuse diagnoses.


RESULTS
The results show that the concurrent validity compared with ICD-10 diagnoses was moderate for both the staff-report measures AUS and DUS and for the self-report measures SMAST-13 and DAST-20. Three out of seven patients under-report alcohol problems and one patient out of seven under-report drug use problems according to consensus ICD-10 substance abuse diagnoses.


CONCLUSIONS
We conclude that the SMAST-13 and DAST-20 in combination with the AUS and DUS, which are easy and quick to perform, are helpful in establishing a common understanding of the patient's alcohol and drug problems in an early intervention clinic.
Møller
Turid
T
St. Olavs University Hospital, Division of Psychiatry, Department of Nidaros DPS, Lade, 7440, Trondheim, Norway.
Linaker
Olav M
OM
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D009664:Norway; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
D013287:Illicit Drugs