Screening for Mental Health Problems among Patients with Substance Use Disorders: Preliminary Findings on the Validation of a Self-Assessment Instrument

Abstract

French

Objectives:

We conducted a preliminary study on the validation of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) among patients seeking treatment for substance use disorders (SUDs).

Method:

We assessed 76 patients with SUDs, using the PDSQ, followed by the Structured Clinical Interview for DSM-IV. Sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curves were calculated.

Results:

Overall, the psychometric properties identified with the PDSQ in patients with SUDs differed from those found in psychiatric outpatient populations. The ROC curves were calculated for major depressive disorder, posttraumatic stress disorder, and panic disorder. The areas under the curves were 0.86 (95%CI, 0.77 to 0.95; P < 0.001), 0.79 (95%CI, 0.68 to 0.90; P < 0.001), and 0.66 (95%CI, 0.51 to 0.82; P = 0.05), respectively.

Conclusion:

The use of the PDSQ to screen for other psychiatric disorders in populations with SUDs is promising but requires larger validation studies to provide data on its psychometric properties and inform the choice of cut-off scores for this population.

Keywords

substance use disorders psychiatric diagnoses screening self-assessment scale validation anxiety disorders mood disorders bulimia nervosa receiver operating characteristic

References

Kessler

. The epidemiology of dual diagnosis. Biol Psychiatry. 2004;56(10):730–737.

Health Canada. Best practices for concurrent mental health and substance use disorders. Ottawa (ON): Health Canada; 2001.

Substance Abuse and Mental Health Services Administration. Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. Rockville (MD): Substance Abuse and Mental Health Services Administration; 2002.

Castel

Rush

Urbanoski

, Overlap of clusters of psychiatric symptoms among clients of a comprehensive addiction treatment service. Psychol Addict Behav. 2006;20(1):28–35.

Zimmerman

Mattia

. A self-report scale to help make psychiatric diagnoses. The psychiatric diagnostic screening questionnaire. Arch Gen Psychiatry. 2001;58(8):787–794.

Streiner

Norman

Health measurement scales. A practical guide to their development and use. 3rd ed. New York (NY): Oxford University Press; 2003. p 172–193. Chapter 10, Validity.

Fischer

Bachmann

Jaeschke

A readers' guide to the interpretation of diagnostic test properties: Clinical example of sepsis. Intensive Care Med. 2003;29(7):1043–1051.

First

Spitzer

Gibbon

, Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). New York (NY): New York State Psychiatric Institute; 2002.

Zimmerman

Mattia

. The Psychiatric Diagnostic Screening Questionnaire: Development, reliability and validity. Compr Psychiatry. 2001;42(3):175–189.

10.

Shapiro

. The interpretation of diagnostic tests. Stat Methods Med Res. 1999;8(2):113–134.

11.

Obuchowski

. Receiver operating characteristic curves and their use in radiology. Radiology. 2003;229(1):3–8.

12.

Zimmerman

The Psychiatric Diagnostic Screening Questionnaire manual. Los Angeles (CA): Western Psychological Services; 2002.

13.

Kessler

Chiu

Demler

, Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–627.

14.

Drake

Mueser

Clark

, The course, treatment, and outcome of substance disorder in persons with severe mental illness. Am J Orthopsychiatry. 1996;66(1):42–51.

15.

Hasin

Grant

. Major depression in 6050 former drinkers: Association with past alcohol dependence. Arch Gen Psychiatry. 2002;59(9):794–800.