How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires

Delgadillo, Jaime; Payne, Scott H.; Gilbody, Simon; Godfrey, Christine; Gore, Stuart; Jessop, Dawn; Dale, Veronica

doi:10.1016/j.jad.2011.06.017

Cited by 54 publications

(36 citation statements)

References 37 publications

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“…Scores range from 0 to 27 with higher scores indicating greater severity. A cut-off score ≥12 has been found to have adequate sensitivity (81%) and specificity (75%) for the detection of a current depressive episode in routine addiction treatment; the measure also has reliable temporal stability (ICC = .78) in this setting which supports its use for outcome monitoring (Delgadillo et al, 2011).…”

Section: Methodsmentioning

confidence: 82%

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Delgadillo

Gore²,

Ali

et al. 2015

Journal of Substance Abuse Treatment

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Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n = 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n = 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24 weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio = 7.14, p = .04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p = .59) or in PDA (p = .08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.

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Section: Methodsmentioning

confidence: 82%

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Delgadillo

Gore²,

Ali

et al. 2015

Journal of Substance Abuse Treatment

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“…This patient group typically have high levels of unemployment (84%), poverty, poor health and social problems in addition to problematic drug and alcohol use. Detailed demographic and clinical characteristics of the sample have been reported elsewhere (Delgadillo et al, 2011).…”

Section: Methodsmentioning

confidence: 99%

Depression, anxiety and comorbid substance use: association patterns in outpatient addictions treatment

Delgadillo

Godfrey

Gilbody

et al. 2013

Mental Health and Substance Use

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Depression and anxiety disorders commonly coexist with drug and alcohol use. Several general population surveys suggest non-linear associations between alcohol and depression symptoms. It is unclear whether such association patterns occur in clinical samples and in the context of poly-substance use. The aim of the study was to investigate the association patterns between substance use and common mental disorder (CMD) severity. Patients accessing a UK outpatient addictions service were recruited sequentially via routine treatment contacts. Psychiatric diagnosis and severity of symptoms were established using the revised clinical interview schedule (CIS-R) structured diagnostic interview; yielding WHO ICD-10 diagnoses for CMD. Data on substance use patterns in the last month and severity of dependence were collected using standardised measures. ANOVA and multivariate regression models were employed to investigate associations between CMD symptom severity and substance use patterns. The results of the multivariate regression analyses indicated a linear association between weekly alcohol use and CIS-R severity; this was statistically significant when adjusting for severity of dependence, poly-substance use, gender and age. Other drug use patterns were not directly associated with overall psychiatric symptom scores, but some evidence was found that specific patterns of drug use correlate with specific psychological symptoms. In conclusion, only alcohol use was significantly associated with psychiatric symptom severity in the context of poly-substance use. Contrary to epidemiological surveys in the general population, no evidence was found for nonlinear associations between CMD and substance use in this clinical sample; nor did we find evidence that recent abstinence increases symptom severity.

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“…The Boston Consortium of Services for Families in Recovery (BCSFR) instrument [15] was tested only in female substance abusers and was found to be a useful screening instrument for detecting posttraumatic stress disorder (PTSD) in women beginning treatment, but not for detecting other mental illnesses. The Patient Health Questionnaire (PHQ) [16] has only been validated for depression in substance users [17]. Others like the Mental Health Screening Form (MHSF-III) have limited validation [18] or have been validated in prison substance-abuse treatment programs, as the Co-Occurring Disorders Screening Instruments (CODSI-MD and CODSI-SMD) [19].…”

Section: Introductionmentioning

confidence: 99%

Dual Diagnosis Screening Interview to Identify Psychiatric Comorbidity in Substance Users: Development and Validation of a Brief Instrument

et al. 2013

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Aim: The objective of this study was to develop and validate a brief tool, the Dual Diagnosis Screening Instrument (DDSI), to screen psychiatric disorders in substance users in treatment and nontreatment-seeking samples. Methods: A total of 827 substance users (66.5% male, mean age 28.6 ± 9.9 years) recruited in treatment (in- and outpatient) and nontreatment (substance user volunteers in university research studies) settings were assessed by trained interviewers using the DDSI and the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) as the criterion standard. Both instruments were administered blind to the results of the other. Disorders obtained with the DDSI were compared to lifetime diagnoses obtained with the PRISM. Sensitivity, specificity, negative, and positive predictive values were estimated. Also test-retest reliability of the DDSI was assessed. Results: The DDSI showed a high sensitivity (=80%) for identifying lifetime depression, mania, psychosis, panic, social phobia, and specific phobia disorders. Specificity was =82% for those diagnoses. Test-retest κ showed excellent agreement (range 81-95%). The mean duration of the DDSI administration was 16.8 ± 2.5 min. Conclusion: The DDSI is a valid and easy-to-administer screening tool to detect possible psychiatric comorbidity among substance users.

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How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires

Cited by 54 publications

References 37 publications

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Depression, anxiety and comorbid substance use: association patterns in outpatient addictions treatment

Dual Diagnosis Screening Interview to Identify Psychiatric Comorbidity in Substance Users: Development and Validation of a Brief Instrument

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