Improving the efficiency of drug use disorder screening in psychiatric settings: validation of a single-item screen

Abstract

Background: Co-occurring drug use disorders are under-detected in psychiatrically ill populations highlighting the need for more efficient screening tools. Objectives: This study compares a single-item screening tool, previously validated in a primary care setting, to the 10-item Drug Abuse Screening Test (DAST-10) for identifying co-occurring drug use disorders among patients with severe psychiatric illness. Methods: A total of 395 patients attending a psychiatric partial hospital program completed both the single-item screen and DAST-10. A subsample of consecutive patients (n = 67) was also administered the Structure Clinical Interview for DSM-IV (SCID-IV) as a diagnostic reference standard. Results: Concordance between screening measures was moderate (κ = 0.4, p < 0.01). Sensitivity and specificity of the single-item screen and DAST-10 as compared to the SCID-IV were comparable, while area under the receiver operating curve showed better discriminatory power for the identification of drug use disorders with the single-item screen. Conclusions: In comparison to the DAST-10, the single-item screen appears to be a more efficient tool to identify co-occurring drug use disorders in a psychiatric treatment setting among patients with a range of psychiatric diagnoses.