Tournier M, Molimard M, Abouelfath A, Cougnard A, Fourrier A, Haramburu F, Bégaud B, Verdoux H
Department of Psychiatry, Université Victor Segalen Bordeaux 2, Hôpital Charles Perrens, 121 rue de la Béchade, 33076 Bordeaux cedex, France.
Acta Psychiatr Scand. 2003 Dec;108(6):410-8. doi: 10.1046/j.0001-690x.2003.00227.x.
To assess the accuracy of self-reported substance use and toxicological assays in subjects admitted for Intentional Drug Overdose (IDO), using as a reference diagnosis of substance use disorder.
Self-reported substance use was collected and toxicological assays were carried out in urine samples in 507 patients with IDO. A standardized psychiatric evaluation was performed in 100 randomly selected subjects.
In routine practice, the emergency department staff did not investigate substance use in nearly one of two patients. Patients' statements and toxicological assays were more specific than sensitive, with lower scores for toxicological assays. Patients' statements made it possible to detect nearly 80% of subjects with substance use disorder.
Identification of substance use disorder in subjects with IDO has strong clinical consequences regarding treatment and prevention of suicidal behaviour. Thus, emergency department staff should be made aware of the value of more systematically exploring self-reported substance use.
以物质使用障碍的参考诊断为依据，评估因故意药物过量（IDO）入院患者自我报告的物质使用情况及毒理学检测的准确性。
收集了507例IDO患者自我报告的物质使用情况，并对其尿液样本进行了毒理学检测。对100名随机挑选的受试者进行了标准化的精神科评估。
在日常实践中，急诊科工作人员对近半数患者未调查其物质使用情况。患者陈述和毒理学检测的特异性高于敏感性，毒理学检测得分较低。患者陈述能够检测出近80%患有物质使用障碍的受试者。
识别IDO患者的物质使用障碍对于自杀行为的治疗和预防具有重要的临床意义。因此，应让急诊科工作人员意识到更系统地探究自我报告的物质使用情况的价值。
