Validity of self-reported psychiatric diagnoses among patients seeking treatment for a substance use disorder

Abstract

Patients seeking treatment for substance use disorders (SUDs) frequently report a history of psychiatric diagnoses, but the validity of these diagnoses is not well established. The study aimed to validate self-reported historical mental diagnoses in patients with an SUD using psychometric tests and structured interviews. This cross-sectional study of participants (n = 30) with an SUD compared their self-reported prior psychiatric diagnoses with current clinical diagnoses based on psychometric tests and structured psychosocial interviews. Of the 11 participants reporting a prior diagnosis of bipolar disorder (BD), only one received a current clinical diagnosis of BD. The historical diagnosis of a personality disorder was confirmed in the two participants reporting this diagnosis, and 15 new diagnoses were made. Bipolar disorder was over-diagnosed in participants with an SUD who instead might have personality disorders. Self-reported psychiatric diagnoses presented by patients for treatment of an SUD should be validated using psychometric tests and medications should be re-evaluated. We recommend that all patients with an SUD be screened for Axis I and II psychiatric diagnoses.

Keywords:

• substance use disorder
• psychiatric diagnoses
• bipolar disorder
• personality disorder
• historical diagnoses

Acknowledgements

The study was supported by a scholarship from the Center for Development of Human Services Research Foundation (Anne Neumann and Paula Yanes) and by the US Department of Health and Human Services training grants 2D55HP05163 (Laurene Tumiel-Berhalter) and 5 D56HP10318 (Lauren L. Valtin). The authors thank Alisa Li, Tenzing Namgyal Lama, and Gaurang Joshi for their help with the data collection, and John Nyquist for his help with the graphics, and Andrew Danzo for his help with editing the manuscript.