Screening for comorbidity in substance abuse clinics

Summary

Principal Investigator: Carlos Blanco
Abstract: Despite our increased understanding of the determinants of substance abuse the treatment of addictive disorders continues to be a major public health problem. Even powerful treatments such as methadone maintenance for opiate dependence have high failure rates and, when patients stay in treatment, they often continue to use psychoactive substances. One reason for this poor outcome may be the high prevalence of comorbid psychiatric disorders in this population. Fortunately, a number of studies has shown the outcome of these patients can improve when their comorbidity is treated. Therefore, increasing the diagnostic accuracy and referral for treatment of this group of patients represents a promising strategy for the treatment of substance abuse disorders. As a first step in that process, this R03 proposal focuses on the adaptation and initial testing of the Patient Health Questionnaire (PHQ) for the diagnosis of psychiatric comorbidity in substance abuse patients, but it is not intended itself to change providers' behaviors. The PHQ is a brief, self-administered instrument that has been extensively studied in a variety of community-based, primary care medical settings. It has been found to accurately identify common psychiatric disorders and has been well accepted due its ease of use and low time demands on patients and staff. It is hoped that the adapted PHQ (Patient Health Questionnaire-Substance Abuse Version; PHQ-SA) will become a patient- and clinician-friendly tool for counselors and other frontline staff to identify patients who could benefit from referral for psychiatric care. Data from this study will help plan future intervention studies that will use our increased ability to diagnose comorbidity to provide appropriate referral and treatment strategies for substance abuse patients in community-based treatment settings.
Funding Period: 2003-09-20 - 2006-07-31
more information: NIH RePORT

Top Publications

  1. ncbi The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Bridget F Grant
    Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism NIAAA, NIH DHHS, 5635 Fishers Lane, Bethesda, MD 20892 9304, USA
    J Clin Psychiatry 66:1351-61. 2005
  2. ncbi Sex differences in subclinical and DSM-IV pathological gambling: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Carlos Blanco
    Department of Psychiatry, Columbia University New York State Psychiatric Institute, New York, NY, USA
    Psychol Med 36:943-53. 2006
  3. ncbi National trends in the outpatient treatment of children and adolescents with antipsychotic drugs
    Mark Olfson
    New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Arch Gen Psychiatry 63:679-85. 2006
  4. pmc The latent structure of marijuana and cocaine use disorders: results from the National Longitudinal Alcohol Epidemiologic Survey (NLAES)
    Carlos Blanco
    Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
    Drug Alcohol Depend 91:91-6. 2007
  5. ncbi National trends in the outpatient diagnosis and treatment of bipolar disorder in youth
    Carmen Moreno
    Unidad de Adolescentes, Hospital General Universitario Gregorio Maranon, Servicio do Psiquiatría, Madrid, Spain
    Arch Gen Psychiatry 64:1032-9. 2007
  6. ncbi Generalizability of clinical trial results for major depression to community samples: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Carlos Blanco
    Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA
    J Clin Psychiatry 69:1276-80. 2008

Scientific Experts

Detail Information

Publications6

  1. ncbi The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Bridget F Grant
    Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism NIAAA, NIH DHHS, 5635 Fishers Lane, Bethesda, MD 20892 9304, USA
    J Clin Psychiatry 66:1351-61. 2005
    ....
  2. ncbi Sex differences in subclinical and DSM-IV pathological gambling: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Carlos Blanco
    Department of Psychiatry, Columbia University New York State Psychiatric Institute, New York, NY, USA
    Psychol Med 36:943-53. 2006
    ..To examine sex differences in DSM-IV subclinical and pathological gambling in nationally representative data of the US population...
  3. ncbi National trends in the outpatient treatment of children and adolescents with antipsychotic drugs
    Mark Olfson
    New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Arch Gen Psychiatry 63:679-85. 2006
    ..Although there are indications that antipsychotic drugs are increasingly used to treat children and adolescents, little is known about the characteristics of those who receive them...
  4. pmc The latent structure of marijuana and cocaine use disorders: results from the National Longitudinal Alcohol Epidemiologic Survey (NLAES)
    Carlos Blanco
    Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
    Drug Alcohol Depend 91:91-6. 2007
    ....
  5. ncbi National trends in the outpatient diagnosis and treatment of bipolar disorder in youth
    Carmen Moreno
    Unidad de Adolescentes, Hospital General Universitario Gregorio Maranon, Servicio do Psiquiatría, Madrid, Spain
    Arch Gen Psychiatry 64:1032-9. 2007
    ..Although bipolar disorder may have its onset during childhood, little is known about national trends in the diagnosis and management of bipolar disorder in young people...
  6. ncbi Generalizability of clinical trial results for major depression to community samples: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Carlos Blanco
    Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA
    J Clin Psychiatry 69:1276-80. 2008
    ..The goal of this study was to assess the proportion of community-dwelling adults with major depressive episode (MDE) who would meet eligibility criteria for a traditional efficacy trial in patients with MDE...