Underdiagnosis of Psychoactive-Substance-lnduced Organic Mental Disorders in Emergency Psychiatry
作者:
SzusterRichard R.,
SchanbacherBridget L.,
McCannSean C.,
McConneilAdrienne,
期刊:
The American Journal of Drug and Alcohol Abuse
(Taylor Available online 1990)
卷期:
Volume 16,
issue 3-4
页码: 319-327
ISSN:0095-2990
年代: 1990
DOI:10.3109/00952999009001593
出版商: Taylor&Francis
数据来源: Taylor
摘要:
The tendency of emergency psychiatrists to make alcohol- and drug-related diagnoses was examined before and after the addition of a standardized psychoactive substance use questionnaire. The addition of the questionnaire resulted in a significant increase in the number of psychoactive-substance-induced organic mental disorder (substance-induced disorder) diagnoses. The questionnaire selectively increased the recognition of nonalcoholic substance-induced disorders while not significantly increasing the diagnoses of alcohol-induced disorders when alcohol was used alone. This suggests that nonalcoholic substance-induced disorders are underdiagnosed in emergency psychiatry. With the increase in the diagnoses of substance-induced disorders, there was a significant decrease in the frequency of psychotic disorder diagnoses and a significant increase in the frequency of adjustment disorder diagnoses. The clinical impact of underdiagnosing and misdiagnosing substance-induced disorders is discussed. Overall, the findings suggest that an increased awareness of substance use history, by the use of a standardized questionnaire, is an effective means of increasing the diagnostic yield of substance-induced disorders in the psychiatric emergency room. Follow-up studies using urine drug screening are recommended.
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