Abstract
ABSTRACT Objectives: This study examined diagnostic errors with patients having comorbid substance abuse and mental disorders, while ruling out the influence of possible confounding subject variables such as chronicity and severity of mental disorder. Methods: Veteran inpatients with dual diagnoses were compared to a control group matched except for the presence of substance abuse. Subjects were diagnosed using a structured diagnostic interview and medical records were reviewed for working diagnoses and mental health treatment history. The frequencies of misdiagnoses were identified by comparing clinician working diagnoses to structured interview diagnoses. Results: Treating clinicians under-diagnosed the presence of substance-induced mental disorders, and alcohol and cocaine abuse (p < .01). Conclusions: The need for more precise diagnostic practices for the substance abusing dually diagnosed patient is affirmed in a well controlled study.
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