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

Chung, Rhoderic K.; Starmer, G. A.; Tattam, Bruce N.; Paton, Michael; Nielssen, Olav

doi:10.1080/15504260903176039

Cited by 5 publications

(12 citation statements)

References 21 publications

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“…Moreover, there appear to be between study differences arising from the way health care was funded. For example, two studies conducted in Australia, where there is universal government funded health care, reported a lack of any association between self‐reports of substance use and substance assay (Chung et al ., ; Galletly et al ., ) while a third Australian study found a very strong association (Fowler et al ., ).…”

Section: Resultsmentioning

confidence: 97%

“…However, this also raises a limitation of this study: that the results might not be typical of all mental health settings. The between study variation in the strength of the association between self‐reporting of substance use and substance assay could be due to the differences in the ability and willingness of patients from different populations to disclose substance use (Chung et al ., ; Galletly et al ., ).…”

Section: Discussionmentioning

confidence: 99%

“…The results of interviews have been compared with urine assays (Galletly et al ., ) or with the assay of blood or hair (Chung et al ., ; Selten et al ., ; Swartz et al ., ), finding varying levels of agreement (Galletly et al ., ; Helseth et al ., ). The extent of agreement between patients’ accounts of substance use and the results of testing depend on the accuracy and sensitivity of the substance assay, the patient's knowledge of the substances they have taken, the treatment setting, the confidence of the patient in the person asking about their substance use, the potential consequences of disclosure and the prevalence of substance use in the population being studied (Chung et al ., ). The benefit of substance assays in mental health settings has not been clearly defined due to (i) conflicting findings about the reliability of disclosure, (ii) the cost of testing, (iii) concern about patients’ privacy and (iv) patients’ capacity to consent to the assay.…”

Section: Introductionmentioning

confidence: 97%

“…In clinical research settings structured or semi‐structured interviews can be used to ensure systematic enquiry about substance use (Barnaby et al ., ; Mallin et al ., , Swartz et al ., ). The results of interviews have been compared with urine assays (Galletly et al ., ) or with the assay of blood or hair (Chung et al ., ; Selten et al ., ; Swartz et al ., ), finding varying levels of agreement (Galletly et al ., ; Helseth et al ., ). The extent of agreement between patients’ accounts of substance use and the results of testing depend on the accuracy and sensitivity of the substance assay, the patient's knowledge of the substances they have taken, the treatment setting, the confidence of the patient in the person asking about their substance use, the potential consequences of disclosure and the prevalence of substance use in the population being studied (Chung et al ., ).…”

Section: Introductionmentioning

confidence: 99%

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Meta‐analysis of self‐reported substance use compared with laboratory substance assay in general adult mental health settings

Smith¹,

Sara

Paton³

et al. 2012

Int J Methods Psych Res

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An accurate assessment of substance use is necessary to make a correct psychiatric diagnosis and to provide appropriate treatment. This study uses meta-analysis to establish the strength of the association between self-reported substance use and the results of laboratory substance assay including the testing for specific substances and screening for any substance use in psychiatric hospitals and in community mental health settings. A systematic search for published studies was supplemented by additional data required for meta-analysis provided by several researchers in this field. Using random-effects meta-analysis, we calculated the pooled estimate of the odds ratio of a positive substance assay in patients reporting use or non-use of substances and estimated the sensitivity, specificity, positive predictive value and negative predictive value. Twenty-six studies met the inclusion criteria. Very strong associations were found between self-reported use and positive tests for cannabis [N = 11 studies, odds ratio (OR) = 22.3; 95% confidence interval (CI) = 10.1-49.1], amphetamines (N = 8, OR = 26.6; 95% CI = 7.9-88.9), cocaine (N = 8, OR = 39.7; 95% CI = 16.2-97.2) and opiates (N = 7, OR = 83.5; 95% CI = 26.7-260.7). Strong associations were found between self-reported use of any substance and positive substance screening (N = 15, OR = 7.2, 95% CI = 3.6-14.1) and tests for alcohol use (N = 5, OR = 8.5; 95% CI = 2.5-28.4). Screening for any substance use had a sensitivity of 61% and a specificity of 66%. Testing for individual substances was specific but lacked sensitivity. Screening has the potential to detect clinically relevant substances that would not be reported by the patient, whereas testing for a specific substance has little advantage over self-report. The sensitivity of the substance assay might be improved by obtaining a sample at the earliest opportunity. Consideration should be given to the increased use of substance screening in general adult mental health settings because it could improve the accuracy of psychiatric diagnosis and increase the likelihood of patients receiving treatment for substance use disorders.

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Section: Resultsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Meta‐analysis of self‐reported substance use compared with laboratory substance assay in general adult mental health settings

Smith¹,

Sara

Paton³

et al. 2012

Int J Methods Psych Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, the study design emphasizes patients in long-term treatment and patients with more frequent consultations, as they were more likely to be receiving treatment at any given time. One possible consequence of this is that the census included relatively more patients with an established relationship with a therapist, among whom the prerequisites for accurate account of the patients' substance use was relatively good [33].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Andersson

Lilleeng

Ruud

et al. 2020

Preprint

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Purpose: The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among the general psychiatric population in Norway.Methods: A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2,358 inpatients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last four weeks (alcohol 2–4 days a week or illicit drug use). Regression analyses controlling for demographic and socio-demographic characteristics were carried out.Results: Substance use was identified in 32.4% of inpatients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among inpatients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. Inpatients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24–29-year-olds and the most socially deprived.Conclusions: This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with severe mental illness, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.

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Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Andersson

Lilleeng

Ruud

et al. 2020

Nordic Journal of Psychiatry

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Purpose: The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among the general psychiatric population in Norway. Methods: A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2358 inpatients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last 4 weeks (alcohol 2-4 days a week or more frequently/illicit drug use). Regression analyses controlling for demographic and sociodemographic characteristics were carried out. Results: Substance use was identified in 32.4% of inpatients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among inpatients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. Inpatients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24 to 29-year-olds and the most socially deprived. Conclusions: This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with schizophrenia and other psychoses, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.

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

Cited by 5 publications

References 21 publications

Meta‐analysis of self‐reported substance use compared with laboratory substance assay in general adult mental health settings

Meta‐analysis of self‐reported substance use compared with laboratory substance assay in general adult mental health settings

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

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