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February 11, 2005
All Adolescents Should be Screened for
Substance Abuse, Study
A study reports that pediatricians should screen all patients
for substance use disorders. In a controlled randomized study
doctors misdiagnosed the majority of subjects.
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Methods
Clinicians utilized a survey created by the authors which
assessed the ability of health care providers to correctly
diagnose child substance abuse disorders. 533 adolescents aged
14 to 18 were used in the study. Responses to the assessment
were compared with the Adolescent Diagnostic Interview (ADI) and
analyzed. The ADI is a structured analytical interview that
yields diagnoses of abuse and dependence according to the
Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition (DSM-IV). Clinicians categorized the degree of substance
use disorder as no use of drugs or alcohol; minimal use; problem
use; abuse; and dependence.
Results
Findings of the study indicated that many subjects were
misdiagnosed. Of the 50 patients that the ADI assessment
classified as having substance disorders only 18 had actual use
problems. In addition, of the 50 individuals classified as
having alcohol or drug use disorders, only 10 were diagnosed
correctly. A separate evaluation of 36 subjects indicated that
none of the individuals were diagnosed correctly. The type or
quality of training of the clinicians was not related to
misdiagnoses.
Conclusion
Authors stated resolving the problem of adolescent substance
abuse starts with having predictable and reliable diagnosis
procedures. They asserted that the severity of substance abuse
problems in young people tends to be overlooked and
miscalculated. Researchers concluded that the problem of false
diagnoses of adolescent substance use disorders could be
remedied if all adolescents, regardless of the appearance of
common behaviors associated with abuse, were screened.
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