Assessment of co-occurring depression and substance use in an ethnically diverse patient sample during behavioral health intake interviews.
Assessment of co-occurring depression and substance use in an ethnically diverse patient sample during behavioral health intake interviews.
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DOI：
10.1016/j.drugalcdep.2012.05.021
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发表时间：
2012-09
影响因子：
4.2
通讯作者：
Alegria, Margarita
中科院分区：
文献类型：
--
作者：
Darghouth, Sarah;Nakash, Ora;Miller, Alisa;Alegria, Margarita
同时发生的疾病给医疗服务提供者带来了挑战，他们往往无法准确诊断这些疾病。本研究探讨了为不同种族患者提供服务的社区卫生诊所中同时发生的抑郁症和药物滥用障碍的评估过程。目标是确定摄入时讨论的症状以及患者和提供者的特征如何与是否接受共存疾病的诊断相关。参与研究包括对摄入情况进行录像、进行半结构化访谈以及完成人口统计和临床测量。根据 119 名抑郁症和药物滥用症状筛查呈阳性的患者的摄入录像带编码的信息进行了定量分析。对诊断为并发疾病的一部分病例 (28) 进行了定性分析。结果表明，女性身份以及任何将“抑郁症”作为通用术语的讨论都会增加被诊断为抑郁症的可能性。讨论吸毒和酗酒的症状增加了接受物质使用障碍诊断的可能性，而讨论物质使用的症状只会增加接受双重诊断的可能性。定性分析表明，提供者报告对药物使用进行了比抑郁症更系统的评估，但定量结果并不支持这一点。我们的结果表明提供者和患者描述双重诊断评估的方式存在差异。非语言信息的作用和患者的表现等因素被认为是导致评估复杂性的因素。
Co-occurring disorders present a challenge for providers who often fail to diagnose them with accuracy. This study explores the assessment process of co-occurring depressive and substance use disorders in community health clinics serving ethnically diverse patients. The goals are to identify how symptoms discussed in intake, as well as patient and provider characteristics, are associated with receiving a diagnosis of co-occurring disorders or not. Participation in the study consisted of videotaping the intake, conducting a semi-structured interview, and completing demographic and clinical measures. Quantitative analyses were conducted based on information coded from videotapes of intakes with 119 patients who screened positive for symptoms of depressive disorders and substance use. A subset of cases (28) diagnosed with co-occurring disorders were qualitatively analyzed. Results suggest that being female and any discussion of “depression” as a general term increased the likelihood of receiving a diagnosis of depression. Discussing symptoms of drug and alcohol use increased the likelihood of receiving a substance use disorder diagnosis, and discussing symptoms of substance use only increased the likelihood of receiving a dual diagnosis. Qualitative analyses indicate that providers report conducting more systematic assessments for substance use than depressive disorders, which is not supported by the quantitative findings. Our results point to discrepancies in the ways providers and patients describe the assessment of dual diagnoses. Factors such as the role of nonverbal information and patient presentation were identified as contributing to complexity of the assessment.
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影响因子：
3.5
作者：
Sleath, B;Svarstad, B;Roter, D
通讯作者：
Roter, D
DOI：
10.1097/01.phh.0000338384.82436.0d
发表时间：
2008-11-01
影响因子：
3.3
作者：
Alegria, Margarita;Nakash, Ora;Normand, Sharon-Lise
通讯作者：
Normand, Sharon-Lise
影响因子：
6
作者：
Burns, L;Teesson, M;O'Neill, K
通讯作者：
O'Neill, K
影响因子：
17.7
作者：
Havassy, BE;Alvidrez, J;Owen, KK
通讯作者：
Owen, KK
影响因子：
6.9
作者：
Davis, Lori;Uezato, Akihito;Frazier, Elizabeth
通讯作者：
Frazier, Elizabeth