The Reliability of Reports of Recent Psychoactive Substance Use at the Time of Admission to an Acute Mental Health Unit

The aim of this study was to examine the accuracy of patients’ accounts of their psychoactive substance use in the week before admission to an acute mental health unit. Fifty consecutively admitted patients undertook a semistructured clinician-administered questionnaire for recent substance use. The results of the interview were compared to the results of gas chromatography mass spectrometry/ mass spectrometry. No patient refused to participate, 46 patients were able to complete the interview, and 48 patients provided a blood sample. Six patients had unreported cocaine or amphetamine in their blood. Cannabis and opiates were not detected in the blood of most of the patients who reported using these drugs. The self-reports of the use of prescription sedatives were inaccurate, but self-reports of recent use of caffeine, nicotine, antidepressants, antipsychotics, and carbamazepine had good overall reliability. Patient reports of recent illicit substance use at the point of admission were found to be unreliable, which may result in incorrect diagnosis and suboptimal treatment of both mental illness and substance-related disorders.

[1]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[2]  M. Swartz,et al.  Alternative Pathways to Violence in Persons with Schizophrenia: The Role of Childhood Antisocial Behavior Problems , 2008, Law and human behavior.

[3]  J. Lieberman,et al.  Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. , 2008, The Journal of clinical psychiatry.

[4]  A. Holbrook,et al.  Systematic Overview of Drug Interactions with Antidepressant Medications , 2006, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[5]  A. Colasanti,et al.  Substance abuse in first-episode schizophrenic patients: a retrospective study , 2006, Clinical practice and epidemiology in mental health : CP & EMH.

[6]  Richard A. Van Dorn,et al.  Substance Use in Persons With Schizophrenia: Baseline Prevalence and Correlates From the NIMH CATIE Study , 2006, The Journal of nervous and mental disease.

[7]  Jack Darkes,et al.  The validity of self-reports of alcohol consumption: state of the science and challenges for research. , 2003, Addiction.

[8]  T. Burns,et al.  Substance misuse in psychiatric inpatients: comparison of a screening questionnaire survey with case notes , 2003, BMJ : British Medical Journal.

[9]  M. Swartz,et al.  Detection of illicit substance use among persons with schizophrenia by radioimmunoassay of hair. , 2003, Psychiatric services.

[10]  R. Mallin,et al.  Detection of Substance Use Disorders in Patients Presenting with Depression , 2002, Substance abuse.

[11]  R. Kahn,et al.  Hair analysis for cannabinoids and amphetamines in a psychosis incidence study , 2002, European Neuropsychopharmacology.

[12]  F. D. Del Boca,et al.  Truth or consequences: the validity of self-report data in health services research on addictions. , 2000, Addiction.

[13]  D. Luchins,et al.  Effects of mandatory drug screens on substance use diagnoses in a mental hospital population. , 1995, The Journal of nervous and mental disease.

[14]  M. Prior,et al.  Urine drug screening of patients admitted to a state psychiatric hospital. , 1993, Hospital & community psychiatry.

[15]  M. First,et al.  The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. , 1992, Archives of general psychiatry.

[16]  F. D. Del Boca,et al.  Self-reports by alcohol and drug abuse inpatients: factors affecting reliability and validity. , 1992, British journal of addiction.

[17]  K. Standage,et al.  An Audit of Substance Use Disorders on a General Hospital Psychiatric Unit * , 1992, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[18]  D S Rae,et al.  Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. , 1990, JAMA.

[19]  G. C. Hancock.  Clinical practice and epidemiology. , 1979, British medical journal.

[20]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[21]  G A Starmer,et al.  EFFECTS OF PSYCHOACTIVE DRUGS ON CAR DRIVING PERFORMANCE: DRUGS IN CRASH‐INVOLVED DRIVERS , 1992, Clinical neuropharmacology.

[22]  H. Conte,et al.  Substance abuse among psychiatric inpatients. , 1992, Comprehensive psychiatry.

[23]  M. Gold,et al.  Role of the laboratory in the evaluation of suspected drug abuse. , 1986, The Journal of clinical psychiatry.

[24]  R. C. Hall,et al.  The effect of unrecognized drug abuse on diagnosis and therapeutic outcome. , 1977, The American journal of drug and alcohol abuse.