Psychometric evaluation of the alcohol use disorders identification test and short drug abuse screening test with psychiatric patients in India.

Abstract

The Alcohol Use Disorders Identification Test (AUDIT) and the short Drug Abuse Screening Test (DAST-10) are brief self-report screens for alcohol and drug problems that have not been evaluated for use with psychiatric patients in developing countries. This study was designed to evaluate the factor structure, reliability, validity, and utility of the AUDIT and the DAST-10 in an Indian psychiatric hospital. Consecutive inpatient admissions from April to December 2001 were sampled. Patients were diagnosed with substance use disorders or psychiatric disorders according to ICD-10 criteria. All patients completed both the AUDIT and the DAST-10 during their intake evaluation. Of the 2286 admissions to the hospital, 1349 were enrolled in the study (30% women); 361 patients (27%) had primary substance use disorders and 988 patients (73%) had primary psychiatric disorders. Both the AUDIT and the DAST-10 were unidimensional and internally consistent. Total scores significantly differentiated the subsamples with primary substance use from those with primary psychiatric disorders (p <.0001). Using cutoff scores of >/= 8 on the AUDIT and >/= 3 on the DAST-10, only 10% (N = 100) of the psychiatric subsample exceeded either cutoff, whereas 99% (N = 358) of the addiction treatment subsample exceeded 1 or both cutoffs. Within the psychiatric subsample, 77% (N = 65) of the patients who were identified as high risk on the AUDIT did not receive an additional alcohol use disorder diagnosis at discharge, and 59% (N = 16) of those identified as high risk on the DAST-10 did not receive an additional discharge diagnosis of drug use disorder. The AUDIT and the DAST-10 demonstrate strong psychometric properties when used in an Indian psychiatric hospital. Routine use of these brief screens can facilitate detection of substance use disorders among psychiatric patients.