title: Using the INTERMED complexity instrument for a retrospective analysis of patients presenting with medical illness, substance use disorder, and other psychiatric illnesses.
abstract: BACKGROUND
  The financial and treatment challenges of complex patients must be addressed with adequate assessment and evaluation. The INTERMED complexity instrument (INTERMED) has been developed for this purpose, but to date has not been used retrospectively. The current study represents a retrospective validity investigation of INTERMED with patients with substance use disorder comorbid with other psychiatric and medical conditions (triple diagnoses). Such patients were expected to generate high complexity scores on the INTERMED instrument.
  
  
  METHODS
  Information on 66 patients with triple diagnoses was submitted to the INTERMED complexity grid. These data were subjected to cluster analysis and other analytic procedures.
  
  
  RESULTS
  Total INTERMED scores reflected elevated complexity for patients with triple diagnoses. As a group, they represented a single cluster of complex patients.
  
  
  CONCLUSIONS
  The validity of the INTERMED complexity assessment was corroborated in relation to retrospective data. In addition to elevations in the biological domain that hospital personnel typically confront, findings related to coping deficiencies and problems in living conditions were noteworthy in requiring comprehensive interventions.
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA, USA. E-mail: steven_thurber@yahoo.com.
authors.forename: William
authors.initials: W
authors.lastname: Meller
authors.forename: Sheila
authors.initials: S
authors.lastname: Specker
authors.forename: Pam
authors.initials: P
authors.lastname: Schultz
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kishi
authors.forename: Steven
authors.initials: S
authors.lastname: Thurber
authors.forename: Roger
authors.initials: R
authors.lastname: Kathol
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis*; D055815:Young Adult