Validation of a brief screening instrument for substance abuse and mental illness in HIV-positive patients

被引:45
作者
Pence, BW
Gaynes, BN
Whetten, K
Eron, JJ
Ryder, RW
Miller, WC
机构
[1] Univ N Carolina, Sch Med, Dept Psychiat, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Sch Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599 USA
[3] Univ N Carolina, Sch Med, Div Infect Dis, Dept Med, Chapel Hill, NC 27599 USA
[4] Duke Univ, Dept Publ Policy, Durham, NC USA
[5] Duke Univ, Dept Community & Family Med, Durham, NC USA
[6] Duke Univ, Hlth Inequal Program, Durham, NC USA
关键词
HIV/AIDS; mental illness; depression; substance abuse; screening instruments;
D O I
10.1097/01.qai.0000177512.30576.9c
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Substance abuse (SA) and mental illness (MI) commonly co-occur with HIV infection in the United States and have important implications for clinical management of HIV/AIDS. Yet SA/Ml often go untreated due in part to a lack of practical, validated screening tools. Setting: HIV clinic in academic medical center. Methods: The 16-item SA/Ml Symptoms Screener (SAMISS) targets SA/Ml in HIV-positive patients. Consecutive consenting HIV-positive patients completed the SAMISS and then a reference standard diagnostic tool, SCID, the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Results: Twenty percent of participants (29/148) had an SA diagnosis and 41% (59/143) had an MI diagnosis in the past year on the SCID; 48% (68/143) had 1 or both. Thirty-seven percent (55/148) screened positive for SA and 69% (99/143) screened positive for NIT on the SAMISS. The SAMISS had 86% (95% CI: 68%-96%) sensitivity and 75% (66%-82%) specificity for SA and 95% (86%-99%) sensitivity and 49% (38%-60%) specificity for MI. Patients with SA were likely to show up as false positives for MI and vice versa. Conclusion: The SAMISS functioned well as a first-line screening tool for SA/Ml in this HIV clinic population. It missed few cases and was easily incorporated into a busy clinical setting. Persons screening positive require a more rigorous confirmatory psychiatric evaluation.
引用
收藏
页码:434 / 444
页数:11
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