Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Dual Diagn. 2020 Jul-Sep;16(3):312-321. doi: 10.1080/15504263.2020.1741755. Epub 2020 Apr 7.
: This study aimed to assess the validity of the psychiatric problems subscale of the Addiction Severity Index (ASI-psych) to ascertain psychiatric comorbidity among individuals participating in randomized controlled trials (RCTs) of substance use disorder (SUD) treatments.: The ASI-psych score among 1,660 RCT participants of National Institute of Drug Abuse Clinical Trials Network studies was compared against diagnosis of any serious mental disorder based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (SCID) or Mini-International Neuropsychiatric Interview (MINI). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for detecting any serious mental disorders were estimated by the receiver operating characteristic (ROC) analysis.: Based on the overall sample, the AUC score for any serious mental disorder was 0.72 (95% confidence interval [CI], [0.69, 0.75]) with the optimal ASI-psych score of 24.6. There was no statistically significant difference in AUCs based on the SCID and MINI ( = 0.05, = .82) or by target drugs of RCTs ( =1.33, = .72).: Results support the utility of the ASI in screening for psychiatric comorbidity among patients receiving SUD treatments in RCT settings.
这项研究旨在评估成瘾严重程度指数(ASI)精神病问题分量表的有效性,以确定参与药物使用障碍(SUD)治疗的随机对照试验(RCT)中的精神共病情况。
对国家药物滥用研究所临床试验网络研究的 1660 名 RCT 参与者的 ASI-psych 评分与根据精神障碍诊断与统计手册第四版(DSM-IV)结构临床访谈或迷你国际神经精神访谈(MINI)的任何严重精神障碍诊断进行了比较。通过受试者工作特征(ROC)分析,估计了用于检测任何严重精神障碍的灵敏度、特异性、阳性预测值(PPV)、阴性预测值(NPV)和曲线下面积(AUC)。
基于总体样本,任何严重精神障碍的 AUC 评分为 0.72(95%置信区间[CI],[0.69,0.75]),最佳 ASI-psych 得分为 24.6。基于 SCID 和 MINI(=0.05,=0.82)或 RCT 的目标药物(=1.33,=0.72),AUC 没有统计学上的显著差异。
结果支持 ASI 在 RCT 环境中筛选接受 SUD 治疗的患者中精神共病的效用。