Carey Kate B, Carey Michael P, Chandra Prabha S
Center for Health and Behavior, Syracuse University, Syracuse, NY 13244-2340, USA.
J Clin Psychiatry. 2003 Jul;64(7):767-74. doi: 10.4088/jcp.v64n0705.
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.
酒精使用障碍识别测试（AUDIT）和简短药物滥用筛查测试（DAST - 10）是针对酒精和药物问题的简短自我报告筛查工具，尚未在发展中国家的精神病患者中进行评估。本研究旨在评估AUDIT和DAST - 10在一家印度精神病医院中的因子结构、可靠性、有效性和实用性。
对2001年4月至12月连续入院的患者进行抽样。根据国际疾病分类第10版（ICD - 10）标准对患者进行物质使用障碍或精神障碍诊断。所有患者在入院评估期间均完成了AUDIT和DAST - 10。
在该医院的2286例入院患者中，1349例纳入研究（30%为女性）；361例患者（27%）患有原发性物质使用障碍，988例患者（73%）患有原发性精神障碍。AUDIT和DAST - 10均为单维度且内部一致。总分能显著区分原发性物质使用障碍亚组和原发性精神障碍亚组（p <.0001）。使用AUDIT得分≥8分和DAST - 10得分≥3分的临界值，精神科亚组中只有10%（N = 100）超过任一临界值，而成瘾治疗亚组中99%（N = 358）超过1个或两个临界值。在精神科亚组中，AUDIT筛查出的高风险患者中有77%（N = 65）在出院时未被额外诊断为酒精使用障碍，DAST - 10筛查出的高风险患者中有59%（N = 16）在出院时未被额外诊断为药物使用障碍。
AUDIT和DAST - 10在印度精神病医院使用时显示出强大的心理测量学特性。常规使用这些简短筛查工具可有助于在精神病患者中检测物质使用障碍。
