title: Substance use disorders assessed using the Kreek-McHugh-Schluger-Kellogg (KMSK) scale in an urban low-income and predominantly African American sample of primary care patients.
abstract: The Kreek-McHugh-Schluger-Kellogg (KMSK) scale was developed to quantify self-exposure to opiates, cocaine, alcohol, and tobacco. The original study was limited by a relatively small sample that was not representative of general clinical populations, and did not include marijuana exposure. For the current study, participants were recruited from primary care outpatient clinics in an urban public hospital. The primary measure was the KMSK scale. The Structured Interview for Diagnosis for DSM-IV (SCID) was used as the "gold standard" for substance dependence diagnoses, and the results of KMSK assessments were evaluated using receiver operator characteristic (ROC) analysis. The sample (n = 439) was predominantly African American (90.6%), with mean age (±SD) of 43.1 ± 12.8 years. ROC analyses found that the optimal cutoff scores for alcohol dependence were the same as suggested previously (11), while they were lower for cocaine dependence (10 vs. 11) and opiate dependence (4 vs. 9). The analysis suggested a cutoff score of 8 for marijuana. The KMSK performed well in the current study as a brief tool for evaluating dependence on alcohol, cocaine, marijuana, and opiates in this nonpsychiatric clinic sample of predominantly poor urban African Americans.
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Atlanta, GA 30322, USA.
authors.forename: Yi-lang
authors.initials: YL
authors.lastname: Tang
authors.forename: Lamya
authors.initials: L
authors.lastname: Khoury
authors.forename: Bekh
authors.initials: B
authors.lastname: Bradley
authors.forename: Charles F
authors.initials: CF
authors.lastname: Gillespie
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Ressler
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Cubells
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000523:psychology*; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014505:Urban Population