Influence of psychoactive substance use on the reliability of psychiatric diagnosis.

The interrater reliability of diagnoses, made on the basis of a structured interview for psychiatric patients with and without psychoactive substance use disorders (PSUDs), was examined. 47 pairs of ratings by 9 different clinical interviewers were used. Results supported 3 major findings: (1) The interrater reliability for non-PSUD psychiatric diagnoses is quite high when an S has no diagnosable PSUD; it is lower, though still substantial when a PSUD is present; (2) interviewers are not aware of this and are just as certain of the accuracy of their diagnoses when a PSUD is present as when one is not; and (3) interrater reliability is moderate to substantial as to the judgment of whether, when a non-PSUD diagnosis is present, it is caused by the use of psychoactive substances. The implications of these findings for the appropriate selection of treatments for dually diagnosed patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological symptoms in methadone maintenance patients: Prevalence and change over treatment.

Methadone maintenance patients in three cities were interviewed twice using the Addiction Severity Index. Of the subjects followed, 35.4% reported having experienced recent psychological symptoms. No relation was found between the length of time in treatment at the first interview and psychiatric severity. In addition, over a 1-year period, the treatment that subjects received from the methadone programs had no impact on psychological symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)