A retrospective study of forty-one consecutively admitted adolescent psychiatric patients who were not referred for substance abuse problems revealed a 71 percent rate of diagnosable abuse. Clinical interview, drug screening, and family history were assessed for their relative contribution to diagnoses. A conduct disorder diagnosis was found to be highly correlated with substance abuse. Both clinical interview and drug screening were found to be useful in diagnosing covert substance abuse. Covert drug abuse is a problem which can be uncovered by a clinical evaluation approach, including systematic clinical interviews and urine drug screening.
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