DETECTION OF SUBSTANCE USE DISORDERS AMONG PSYCHIATRIC-INPATIENTS

This study examines the utility of the Addiction Severity Index (ASI) for detecting psychoactive substance use disorders (PSUDs) among psych iatric inpatients. Four hundred thirty-five inpatients at two inner-ci ty psychiatric hospitals completed the ASI and the Structured Clinical Interview for DSM-III-R (SCID). Receiver operating characteristic (RO C) analysis assessed the optimal threshold ASI alcohol and drug compos ite scores to detect DSM-III-R PSUDs. The correlations of both the ASI alcohol and drug composite scores with their corresponding DSM-III-R PSUD categories were significant (p<.0001). However, the ROC analysis revealed that the ASI misses approximately 20% of SCID-positive PSUD c ases. Specificity of the ASI, on the other hand, is quite good (95% to 98%), and optimal ASI threshold scores to rule out a PSUD among these patients are identified. The results also support the sensitivity of these patients to the toxic effects of illicit substance use.