OBJECTIVE: To assess the prevalence of psychoactive substance use disorders (PSUDs) among a large, unselected group of seriously injured trauma center patients, using a standardized diagnostic interview and criteria. DESIGN: Prevalence study. SETTING: A level I regional trauma center. PATIENTS: Trauma center patients fulfilling the following criteria were eligible subjects: aged 18 years or older, admission from injury scene, length of stay of 2 days or longer, and intact cognition. OUTCOME MEASURES: The PSUDs were diagnosed using the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) and were categorized as abuse or dependence and past or current (within past 6 months). The SCID results were analyzed with respect to demographic factors, injury type, and blood alcohol concentration and urine toxicology results, using chi2 and logistic regression techniques. RESULTS: Of the 1220 patients approached for study, 1118 (91.6%) consented. More than half (54.2%) had a diagnosis of a PSUD in their lifetime. Approximately 90% of alcohol and other drug use diagnoses were for dependence and more than 62% were current. Overall, 24.1% of patients were currently alcohol dependent (men, 27.7%; women, 14.7%; P<.001), and 17.7% were currently dependent on other drugs (men, 20.2%; women, 11.2%; P<.001). Current alcohol dependence rates were not associated with race; rates of dependence on other drugs were higher among nonwhites and victims classified with intentional injuries. While 54.3% of blood alcohol-positive patients were currently alcohol dependent and 38.7% of patients with positive urine screening test results for drugs other than alcohol and nicotine were currently drug dependent, 11.7% of blood alcohol-negative and 3.9% of drug-negative patients, respectively, had current diagnoses of dependence on psychoactive substances. CONCLUSIONS: A high percentage of seriously injured trauma center patients are at risk of having current PSUDs. Patients with positive toxicology screening test results and/or positive screening questionnaire responses should be referred for formal evaluation and treatment.
OBJECTIVE: To assess the prevalence of psychoactive substance use disorders (PSUDs) among a large, unselected group of seriously injured trauma centerpatients, using a standardized diagnostic interview and criteria. DESIGN: Prevalence study. SETTING: A level I regional trauma center. PATIENTS: Trauma centerpatients fulfilling the following criteria were eligible subjects: aged 18 years or older, admission from injury scene, length of stay of 2 days or longer, and intact cognition. OUTCOME MEASURES: The PSUDs were diagnosed using the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) and were categorized as abuse or dependence and past or current (within past 6 months). The SCID results were analyzed with respect to demographic factors, injury type, and blood alcohol concentration and urine toxicology results, using chi2 and logistic regression techniques. RESULTS: Of the 1220 patients approached for study, 1118 (91.6%) consented. More than half (54.2%) had a diagnosis of a PSUD in their lifetime. Approximately 90% of alcohol and other drug use diagnoses were for dependence and more than 62% were current. Overall, 24.1% of patients were currently alcohol dependent (men, 27.7%; women, 14.7%; P<.001), and 17.7% were currently dependent on other drugs (men, 20.2%; women, 11.2%; P<.001). Current alcohol dependence rates were not associated with race; rates of dependence on other drugs were higher among nonwhites and victims classified with intentional injuries. While 54.3% of blood alcohol-positive patients were currently alcohol dependent and 38.7% of patients with positive urine screening test results for drugs other than alcohol and nicotine were currently drug dependent, 11.7% of blood alcohol-negative and 3.9% of drug-negative patients, respectively, had current diagnoses of dependence on psychoactive substances. CONCLUSIONS: A high percentage of seriously injured trauma centerpatients are at risk of having current PSUDs. Patients with positive toxicology screening test results and/or positive screening questionnaire responses should be referred for formal evaluation and treatment.
Authors: Erik G Van Eaton; Douglas F Zatzick; Thomas H Gallagher; Peter Tarczy-Hornoch; Frederick P Rivara; David R Flum; Roselyn Peterson; Ronald V Maier Journal: J Am Coll Surg Date: 2014-04-21 Impact factor: 6.113
Authors: Douglas F Zatzick; Ali Rowhani-Rahbar; Jin Wang; Joan Russo; Doyanne Darnell; Leah Ingraham; Lauren K Whiteside; Roxanne Guiney; Margot Kelly Hedrick; Frederick P Rivara Journal: Psychiatr Serv Date: 2017-02-01 Impact factor: 3.084
Authors: C C H M van Delft-Schreurs; J J M van Bergen; P van de Sande; M H J Verhofstad; J de Vries; M A C de Jongh Journal: Qual Life Res Date: 2013-11-08 Impact factor: 4.147
Authors: Francine Terrell; Douglas F Zatzick; Gregory J Jurkovich; Frederick P Rivara; Dennis M Donovan; Christopher W Dunn; Carol Schermer; Jay Wayne Meredith; Larry M Gentilello Journal: J Am Coll Surg Date: 2008-07-14 Impact factor: 6.113