The relationship between the Hopkins symptom checklist-10 and diagnoses of anxiety and depression among inpatients with substance use disorders

Abstract

Introduction

The Hopkins Symptom Checklist-10 (HSCL-10) is a self-report inventory of anxiety and depression symptoms that may assist clinicians in screening for clinical conditions among patients with substance use disorder (SUD). We examined the HSCL-10 as a screening tool for anxiety and depressive disorders within a general population of SUD inpatients.

Methods

We used data from a cohort study of 611 SUD inpatients. Receiver operating characteristic (ROC) analyses were conducted, with and without covariates, to evaluate the potential of the HSCL-10 as a screening tool. This was explored using any anxiety disorder, especially posttraumatic stress disorder (PTSD), and any mood disorder, especially major depressive disorders, as the outcome criteria. Candidate covariates included gender, age, education, polydrug use and treatment center.

Results: The HSCL-10 had a moderate ability to identify caseness (i.e. having or not having a clinical diagnosis) according to each outcome criterion, with the area under the ROC curve (AUC) varying from 0.64 to 0.66. Adding relevant covariates markedly enhanced the instrument’s ability to identify those who met the criteria for any anxiety disorder (AUC = 0.77), especially PTSD (AUC = 0.82).

Conclusion

In a real-world clinical setting, the HSCL-10 has fair-to-good clinical utility for identifying SUD inpatients who have comorbid clinical symptoms of anxiety disorders or PTSD, when combined with common background variables. The HSCL-10, a brief self-report screening tool, may serve as an efficient proxy for comprehensive interviews used in research and for clinical anxiety symptom screening among patients with SUD.

Keywords:

• Self-report symptoms
• substance use disorders
• post-traumatic stress disorder
• major depressive disorder
• receiver operating characteristic

Acknowledgements

We thank the research assistants at the participating clinics for their contributions to implementing the study: Marit Magnussen, Kristin Øyen Kvam, Snorre Rønning, Eli Otterholt, Merethe Wenaas, Kristian Bachmann and Helene Tjelde. We also thank the participating patients for their contributions to this research.

Authors’ contribution

HWA: Conceptualization, Formal analysis, Writing – Original draft preparation, Final Editing. TN: Writing- Reviewing and Editing, Data analyses. MPM: Supervision, Data analyses, Writing- Reviewing and Editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was supported by the Norwegian University of Science and Technology, Trondheim, Norway; St. Olav’s University Hospital, Trondheim, Norway; and Møre and Romsdal Hospital Trust, Ålesund, Norway. The funding sources had no role in the study design, data collection, analyses, writing or decision to submit the manuscript for publication.