title: The use of screening instruments for detecting alcohol and other drug use disorders in first-episode psychosis.
abstract: The high rate of drug abuse among patients with psychosis represents a challenge to clinicians in their treatment of the patients. Powerful screening tools to detect problematic drug use in an early phase of psychotic illness are needed. The aim of the present study was to investigate prevalence of drug use disorders and psychometric properties of the Alcohol Use Disorder Identification Test (AUDIT) and the Drug Use Disorder Identification Test (DUDIT) in 205 first-episode psychosis patients in Oslo, Norway. Internal consistency of the instruments and criterion-based validity as compared to a current DSM-IV diagnosis of abuse or dependence of alcohol or other drugs were analyzed. Fifteen percent of the men and 11% of the women had a DSM-IV diagnosis of alcohol use disorders while 33% of the men and 16% of the women had non-alcohol drug use disorders. The instruments were reliable (Cronbach's alpha above 0.90) and valid (Area under the curve above 0.83). Suitable cut-off scores (sensitivity >0.80 and specificity >0.70) were ten for men and eight for women on AUDIT and three for men and one for women on DUDIT. The results of this study suggest that AUDIT and DUDIT are powerful screening instruments for detecting alcohol and other drug use disorders in patients with first-episode psychosis.
authors.affiliation: Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway. ragnar.nesvag@medisin.uio.no
authors.forename: Ragnar
authors.initials: R
authors.lastname: Nesvåg
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Lange
authors.forename: Ann
authors.initials: A
authors.lastname: Faerden
authors.forename: Elizabeth Ann
authors.initials: EA
authors.lastname: Barrett
authors.forename: Björn
authors.initials: B
authors.lastname: Emilsson
authors.forename: Petter Andreas
authors.initials: PA
authors.lastname: Ringen
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Ingrid
authors.initials: I
authors.lastname: Agartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult