Missed Diagnosis of Substance Abuse in Psychiatric Patients

Ananth, Jambur; Vandewater, Steve; Kamal, Moffaque; Brodsky, Annette M.; Gamal, Reda; Miller, M. K.

doi:10.1176/ps.40.3.297

Cited by 113 publications

(92 citation statements)

References 4 publications

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“…For the latter, the moderate-to-extreme range of impairment scores (4 to 9) was selected to approximate a severity range of substance abuse to substance dependence as reflected in DSM-IV criteria for a SUD. 49 Using diagnostic information alone tends to underestimate the prevalence of co-occurring disorders 22,50,51 ; therefore, we developed a composite measure by combining the CCAR functional ratings and recorded diagnosis. Clients were designated as having a co-occurring disorder if there was a recorded diagnosis of a SUD or they had a moderateto-extreme rating on the CCAR substance abuse item.…”

Section: Identification Of Co-occurring Disordersmentioning

confidence: 99%

Prevalence and Profile of People with Co-Occurring Mental and Substance Use Disorders within a Comprehensive Mental Health System

Rush

Koegl

2008

Can J Psychiatry

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Objective: To examine the prevalence and profile of people with co-occurring mental and substance use disorders in relation to numerous demographic, diagnostic, and needs-related variables across a comprehensive system of mental health services using a standard methodology.Method: Data were collected on cases (n = 9839) sampled from specialty tertiary inpatient, specialty outpatient, and community-based mental health programs. Status with respect to co-occurring disorders was based on recorded diagnosis of substance use disorder and the substance abuse measure within the Colorado Client Assessment Record. The demographic and needs profile was compared across groups with or without co-occurring disorders within each level of care.Results: Overall, the prevalence of co-occurring disorders was 18.5%, and highest among clients receiving specialty tertiary inpatient care (28%), and within selected subpopulations such as younger adults (55%) and those with personality disorders (34%). There were few differences between groups based on co-occurring disorders in the specialty inpatient programs. For outpatient and community settings, the clients with co-occurring disorders were distinguished by a more impaired and complex needs profile and more likely to be young, single, male, and of low education. Across all levels of care, having a co-occurring disorder was strongly associated with antisocial and challenging behaviour, legal involvement, and risk of suicide or self-harm. Conclusion:The prevalence estimate of co-occurring disorders is likely representative of a multilevel system of care that serves a large, mixed urban and rural population. Results highlight the need to focus on specific subpopulations and sectors in pursuit of more integrated treatment and support for their mental health and addictions problems. Can J Psychiatry 2008;53(12):810-821Clinical Implications · Clinicians can use sociodemographic characteristics, such as male sex, younger age, and being unemployed, and clinical indicators, such as overall mental health severity and behavioural challenges, to help identify and support people with substance use disorders. · Treatment and support models for co-occurring mental and substance use disorders must include risk management strategies, given the higher prevalence of challenging behaviours within this population. · There is a need for system-wide planning regarding co-occurring mental and substance use disorders. Limitations· Although findings were based on a comprehensive mental health system, the results may not be applicable to every jurisdiction. · Study findings should not necessarily be generalized to acute care, consumer, or peer support programs because they were not included in our study. · Clinical diagnostic interviews were not feasible to validate study criteria for defining co-occurring disorders.

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Section: Identification Of Co-occurring Disordersmentioning

confidence: 99%

Prevalence and Profile of People with Co-Occurring Mental and Substance Use Disorders within a Comprehensive Mental Health System

Rush

Koegl

2008

Can J Psychiatry

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“…Studies comparing urine analysis to routine clinical practice, structured interviews and patient self-reports have reported under-detection of recent substance intake (65,66,81,116,117).…”

Section: Under Detectionmentioning

confidence: 99%

“…With the use of immunological urine methods, some previous studies conclude that routine urine screening is useful (84,90,116), especially among psychotic patients who may be unwilling or unable to provide a proper history (66,70,117). Another study recommends the use of routine toxicological screening as a supplement to structured assessment (72), whereas other studies recommend the use of structured interviews rather than routine screening (65,69,142).…”

mentioning

confidence: 99%

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Mordal

Bramness

Holm

et al. 2008

General Hospital Psychiatry

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“…10 Further a life time prevalence of drug dependence was found in 36.8% of schizophrenics. 11 In another recent study in a sample of 205 psychiatric inpatients 76% of men and 34% of women admitted use of substance. Of the current users, 61.8% were schizophrenics.…”

Section: Prevalence Of Substance Abuse In Schizophrenicsmentioning

confidence: 96%

Comparison of Sociodemographic and Clinical Variables in Schizophrenics With and Without Substance Abuse

Rajashekharaiah¹,

Verma²

2016

jemds

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Missed Diagnosis of Substance Abuse in Psychiatric Patients

Cited by 113 publications

References 4 publications

Prevalence and Profile of People with Co-Occurring Mental and Substance Use Disorders within a Comprehensive Mental Health System

Prevalence and Profile of People with Co-Occurring Mental and Substance Use Disorders within a Comprehensive Mental Health System

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Comparison of Sociodemographic and Clinical Variables in Schizophrenics With and Without Substance Abuse

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