title: CRAFFT as a Substance Use Screening Instrument for Adolescent Psychiatry Admissions.
abstract: BACKGROUND
  Adolescent use of alcohol and illicit substances is quite common among pediatric psychiatry inpatients; however, little data exist on substance use screening instruments that can be used to augment thorough psychiatric diagnostic interviews. CRAFFT is a screening tool for adolescent substance use that has been validated in outpatient general medical settings. This is the first study to examine its use in adolescent psychiatric inpatients.
  
  
  METHODS
  We performed a chart review of records from adolescents admitted to our inpatient psychiatric unit who completed a CRAFFT screen on admission. We compared CRAFFT scores with other measures of substance use, including urine drug screens and the diagnosis of a substance use disorder at discharge. We also examined measures of depression and suicidality in individuals with elevated CRAFFT scores (≥2 positive answers out of 6) and compared them with measures in those with normal CRAFFT scores.
  
  
  RESULTS
  Elevated CRAFFT scores were correlated with other measures of alcohol and substance use, including the diagnosis of a substance use disorder at discharge (P<0.0001), and laboratory screening for alcohol (P=0.0048) and marijuana (P<0.0001) on admission. Previous suicide attempts (P=0.005) and "psychiatric trauma" (P=0.0027) were also positively associated with elevated CRAFFT scores.
  
  
  CONCLUSIONS
  CRAFFT scores in adolescent inpatients were correlated with other measures of substance use, supporting its efficacy as a screening tool in this population. CRAFFT scores were also positively correlated with a history of psychiatric trauma and past suicide attempts, which is consistent with the results of previous studies associating pediatric substance use and traumatic life events with an increased risk of suicide.
authors.affiliation: OESTERLE, HITSCHFELD, LINEBERRY, and SCHNEEKLOTH: Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Tyler S
authors.initials: TS
authors.lastname: Oesterle
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Hitschfeld
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Lineberry
authors.forename: Terry D
authors.initials: TD
authors.lastname: Schneekloth
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D000067073:Psychological Trauma / Q000453:epidemiology; D012107:Research Design; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology; D014481:United States / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs