title: Drug screens for psychiatric patients in the emergency department: evaluation and recommendations.
abstract: OBJECTIVE
  To better understand how toxicology screening for psychiatric patients in the emergency department (ED) setting affects diagnostic decisions.
  
  
  METHODS
  Retrospective chart review of 439 ED visits of adult patients receiving psychiatry consultations at two hospitals, one an academic medical center (n =224) and the other a community hospital (n = 220), between July 2008 and February 2009. Clinical, demographic, and ED length of stay (LOS) information was abstracted from the psychiatry consultation notes and the medical records.
  
  
  RESULTS
  Positive urine toxicology results, when combined with a basic substance abuse history, were not associated independently with a patient's receiving a substance-related diagnosis as part of the psychiatric assessment. By contrast, a positive blood alcohol level was associated independently with a patient's receiving one of these diagnoses while a positive alcohol use history was not.
  
  
  CONCLUSIONS
  Urine toxicology screens do not add significant diagnostic value to all ED psychiatric evaluations when combined with standard substance use histories.
authors.affiliation: Department of Psychiatry, Brigham and Women's Hospital. dskroll@partners.org
authors.forename: David S
authors.initials: DS
authors.lastname: Kroll
authors.forename: Jennifer
authors.initials: J
authors.lastname: Smallwood
authors.forename: Grace
authors.initials: G
authors.lastname: Chang
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology