title: Improving the efficiency of drug use disorder screening in psychiatric settings: validation of a single-item screen.
abstract: BACKGROUND
  Co-occurring drug use disorders are under-detected in psychiatrically ill populations highlighting the need for more efficient screening tools.
  
  
  OBJECTIVE
  This study compares a single-item screening tool, previously validated in a primary care setting, to the 10-item Drug Abuse Screening Test (DAST-10) for identifying co-occurring drug use disorders among patients with severe psychiatric illness.
  
  
  METHODS
  A total of 395 patients attending a psychiatric partial hospital program completed both the single-item screen and DAST-10. A subsample of consecutive patients (n = 67) was also administered the Structure Clinical Interview for DSM-IV (SCID-IV) as a diagnostic reference standard.
  
  
  RESULTS
  Concordance between screening measures was moderate (κ = 0.4, p < 0.01). Sensitivity and specificity of the single-item screen and DAST-10 as compared to the SCID-IV were comparable, while area under the receiver operating curve showed better discriminatory power for the identification of drug use disorders with the single-item screen.
  
  
  CONCLUSIONS
  In comparison to the DAST-10, the single-item screen appears to be a more efficient tool to identify co-occurring drug use disorders in a psychiatric treatment setting among patients with a range of psychiatric diagnoses.
authors.affiliation: Department of Psychology, Boston University , MA .
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Hearon
authors.forename: Casey L
authors.initials: CL
authors.lastname: Pierce
authors.forename: Thröstur
authors.initials: T
authors.lastname: Björgvinsson
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.forename: Shelly F
authors.initials: SF
authors.lastname: Greenfield
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.forename: Alisa B
authors.initials: AB
authors.lastname: Busch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Assessment; co-occurring substance use disorders; dual diagnosis; psychiatric treatment; questionnaire; screening