Improving the efficiency of drug use disorder screening in psychiatric settings: validation of a single-item screen

Abstract

Background: Co-occurring drug use disorders are under-detected in psychiatrically ill populations highlighting the need for more efficient screening tools. Objectives: This study compares a single-item screening tool, previously validated in a primary care setting, to the 10-item Drug Abuse Screening Test (DAST-10) for identifying co-occurring drug use disorders among patients with severe psychiatric illness. Methods: A total of 395 patients attending a psychiatric partial hospital program completed both the single-item screen and DAST-10. A subsample of consecutive patients (n = 67) was also administered the Structure Clinical Interview for DSM-IV (SCID-IV) as a diagnostic reference standard. Results: Concordance between screening measures was moderate (κ = 0.4, p < 0.01). Sensitivity and specificity of the single-item screen and DAST-10 as compared to the SCID-IV were comparable, while area under the receiver operating curve showed better discriminatory power for the identification of drug use disorders with the single-item screen. Conclusions: In comparison to the DAST-10, the single-item screen appears to be a more efficient tool to identify co-occurring drug use disorders in a psychiatric treatment setting among patients with a range of psychiatric diagnoses.

• Assessment
• co-occurring substance use disorders
• dual diagnosis
• psychiatric treatment
• questionnaire
• screening

Acknowledgements

The authors gratefully acknowledge the funding support from the Health Services Research Division and McLean Hospital for this study. Dr Weiss would like to acknowledge support from the following funding sources: NIDA U10DA15831 and K24DA02288 and Dr Greenfield from the following from K24DA019855.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.