Diagnostic capabilities of self-reported psychoactive substance use among patients admitted to psychiatric consultations in Benin, West Africa.
ASSIST
Benin
Concordance
Psychoactive substance use
Self-report
Urine test
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
30 11 2022
30 11 2022
Historique:
received:
30
08
2022
accepted:
15
11
2022
entrez:
30
11
2022
pubmed:
1
12
2022
medline:
3
12
2022
Statut:
epublish
Résumé
There is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin. A cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants' self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated. The frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746-0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441-0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants' were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV). Diagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.
Sections du résumé
BACKGROUND
There is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin.
METHODS
A cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants' self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated.
RESULTS
The frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746-0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441-0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants' were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV).
CONCLUSION
Diagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.
Identifiants
pubmed: 36451144
doi: 10.1186/s12888-022-04394-0
pii: 10.1186/s12888-022-04394-0
pmc: PMC9714013
doi:
Substances chimiques
Ethanol
3K9958V90M
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
752Informations de copyright
© 2022. The Author(s).
Références
Child Adolesc Psychiatr Clin N Am. 2016 Jul;25(3):549-65
pubmed: 27338974
J Psychoactive Drugs. 2020 Jan-Mar;52(1):56-65
pubmed: 31918627
Mayo Clin Proc. 2008 Jan;83(1):66-76
pubmed: 18174009
J Ethn Subst Abuse. 2021 Aug 4;:1-11
pubmed: 34348077
Addiction. 2008 Jun;103(6):1039-47
pubmed: 18373724
BMC Psychiatry. 2011 Feb 12;11:25
pubmed: 21314980
Addict Behav. 2013 Oct;38(10):2568-74
pubmed: 23811060
Addict Behav. 2006 Sep;31(9):1661-9
pubmed: 16446045
Pediatrics. 2011 Nov;128(5):e1330-40
pubmed: 22042818
Addict Behav. 2012 Mar;37(3):225-33
pubmed: 22143002
Subst Use Misuse. 2018 Aug 24;53(10):1756-1761
pubmed: 29419341
Subst Abuse Treat Prev Policy. 2021 Feb 27;16(1):20
pubmed: 33639969
Am J Emerg Med. 2001 Jan;19(1):49-51
pubmed: 11146019
Clin Toxicol (Phila). 2008 Mar;46(3):239-42
pubmed: 18344106
J Subst Abuse Treat. 2014 Jul;47(1):93-101
pubmed: 24629887
Niger Postgrad Med J. 2020 Jul-Sep;27(3):230-236
pubmed: 32687124
Toxicol Commun. 2019;3(1):94-101
pubmed: 32051924
Subst Abus. 2011 Oct;32(4):238-41
pubmed: 22014254
J Ethn Subst Abuse. 2022 Apr-Jun;21(2):538-552
pubmed: 32677552
Subst Use Misuse. 2005;40(3):299-311
pubmed: 15776978
Lancet Psychiatry. 2018 Dec;5(12):987-1012
pubmed: 30392731
Addiction. 2002 Sep;97(9):1183-94
pubmed: 12199834
Basic Clin Pharmacol Toxicol. 2022 Sep;131(3):205-213
pubmed: 35706341
Psychiatr Prax. 2000 Nov;27(8):367-71
pubmed: 11140158
Int J Environ Res Public Health. 2020 Jan 29;17(3):
pubmed: 32013178
Am J Psychiatry. 2001 Aug;158(8):1181-3
pubmed: 11481146
Addict Behav. 2010 Jul;35(7):667-72
pubmed: 20223601
Subst Use Misuse. 2019;54(8):1337-1344
pubmed: 30860932
Niger Postgrad Med J. 2018 Jan-Mar;25(1):8-12
pubmed: 29676338