Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T13:34:11.786Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of self-reports and biological measures for alcohol, tobacco, and illicit drugs consumption in psychiatric inpatients

Published online by Cambridge University Press:  16 April 2020

Renaud de Beaurepaire ,
Michael Lukasiewicz ,
Patrick Beauverie ,
Sophie Castéra ,
Odile Dagorne ,
Renaud Espaze ,
Bruno Falissard ,
Patrick Giroult ,
Michèle Houery  and
Georges Mahuzier
...Show all authors
Renaud de Beaurepaire*
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France INSERM U-513, 94010Créteil, France
Michael Lukasiewicz
Affiliation:
INSERM U-669, PSIGIAM, 97 boulevard de Port-Royal, 75679Paris cedex 14, France
Patrick Beauverie
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Sophie Castéra
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Odile Dagorne
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Renaud Espaze
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Bruno Falissard
Affiliation:
INSERM U-669, PSIGIAM, 97 boulevard de Port-Royal, 75679Paris cedex 14, France
Patrick Giroult
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Michèle Houery
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Georges Mahuzier
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Isabelle Matheron
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Philippe Niel
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Pierre Padovani
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Nicole Poisson
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Jean-Paul Richier
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Jérôme Rocher
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Odile Ruetsh
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Didier Touzeau
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
André Visinoni
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
Robert Molimard
Affiliation:
CH Paul Guiraud, 54, avenue de la République, 94806Villejuif, France
*
*Corresponding author. Secteur 94G11, CH Paul Guiraud, 54, avenue de la République, 94806 Villejuif, France. Tel.: +331 421 17088; fax: +331 421 17089. E-mail address: debeaurepaire@wanadoo.fr (R. de Beaurepaire).
Get access

Abstract

Background

Asking psychiatric in-patients about their drug consumption is unlikely to yield reliable results, particularly where alcohol and illicit drug use is involved. The main aim of this study was to compare spontaneous self-reports of drug use in hospitalized psychiatric patients to biological measures of same. A secondary aim was to determine which personal factors were associated with the use of tobacco, alcohol, and illicit drugs as indicated by these biological measures.

Methods

The consumption of substances was investigated using biological measures (urine cotinine, cannabis, opiates, cocaine, amphetamines and barbiturates; blood carbohydrate-deficient transferrin [CDT] and gamma-glutamyl transferase [GGT]) in 486 consecutively admitted psychiatric patients, one day following their hospitalization. Patients’ self-reports of alcohol, tobacco and illicit drugs consumption were recorded. Socio-professional and familial data were also recorded.

Results

The results show a low correlation between biological measures and self-reported consumption of alcohol and illicit drugs. Fifty-two percent of the patients under-reported their consumption of illicit drugs (kappa = .47). Patients with schizophrenia and personality disorders were more likely to disclose their illicit drug consumption relative to patients suffering from mood disorders and alcohol dependence. Fifty-six percent of patients underreported alcohol use, as evaluated by CDT (kappa = .2), and 37% underreported when using the CDT + GGT measure as an indicator. Smoking appeared to be reported adequately. In the study we observed a strong negative correlation between cannabis use and age, a strong correlation between tobacco and cannabis use, and correlations between tobacco, cannabis and alcohol consumption.

Conclusion

This study is the first to compare self-reports and biological measures of alcohol, tobacco and illicit drug uses in a large sample of inpatients suffering from various categories of psychiatric illnesses, allowing for cross-diagnosis comparisons.

Keywords

Biological measureMentally illSelf-reportCotinineCannabisCDTGGT
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 8 , November 2007 , pp. 540 - 548
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarons, G.A., Brown, S.A., Coe, M.T., Myers, M.G., Garland, A.F., Ezzet-Lofstram, R.et al.Adolescent alcohol and drug abuse and health. J Adolesc Health 1999;24:412–421.CrossRefGoogle ScholarPubMed
Adlaf, E.M., Paglia, A., Ivis, F.J., Ialomiteanu, A.Nonmedical drug use among adolescent students: highlights from the 1999 Ontario Student Drug Use Survey. CMAJ 2000;162:177–180.Google ScholarPubMed
Akinci, I.H., Tarter, R.E., Kirisci, L.Concordance between verbal report and urine screen of recent marijuana use in adolescents. Addict Behav 2001;26:613–619.CrossRefGoogle ScholarPubMed
Arseneault, L., Cannon, M., Witton, J., Murray, R.M.Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry 2004;184:110–117.CrossRefGoogle Scholar
Boys, A., Farrell, M., Taylor, C., Marsden, J., Goodman, R., Brugha, T.et al.Psychiatric morbidity and substance use in young people aged 13–15 years: results from the Child and Adolescent Survey of Mental Health. Br J Psychiatry 2003;182:509–517.CrossRefGoogle ScholarPubMed
Brady, K., Casto, S., Lydiard, R.B., Malcolm, R., Arana, G.Substance abuse in an inpatient psychiatric sample. Am J Drug Alcohol Abuse 1991;17:389–397.CrossRefGoogle Scholar
Claassen, C.A., Gilfillan, S., Orsulak, P., Carmody, T.J., Battaglia, J., Rush, A.J.Substance use among patients with a psychotic disorder in a psychiatric emergency room. Psychiatr Serv 1997;48:353–358.Google Scholar
Cook, R.F., Bernstein, A.D., Arrington, T.L., Andrews, C.M., Marshall, G.A.Methods for assessing drug use prevalence in the workplace: a comparison of self-report, urinalysis, and hair analysis. Int J Addict 1995;30:403–426.CrossRefGoogle ScholarPubMed
DeSchepper, P.J., Van Hecken, A., Van Rossum, J.M.Kinetics of cotinine after oral and intravenous administration to man. Eur J Clin Pharmacol 1987;31:583–588.CrossRefGoogle Scholar
Dixon, L.Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes. Schizophr Res 1999;35(Suppl.):S93–S100.CrossRefGoogle ScholarPubMed
Farrell, M., Howes, S., Bebbington, P., Brugha, T., Jenkins, R., Lewis, G.et al.Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey. Br J Psychiatry 2001;179:432–437.CrossRefGoogle ScholarPubMed
Farrell, M., Howes, S., Taylor, C., Lewis, G., Jenkins, R., Bebbington, P.et al.Substance misuse and psychiatric comorbidity: an overview of the OPCS national psychiatric morbidity survey. Addict Behav 1998;23:909–918.CrossRefGoogle ScholarPubMed
Fowler, I.L., Carr, V.J., Carter, N.T., Lewin, T.J.Patterns of current and lifetime substance use in schizophrenia. Schizophr Bull 1998;24:443–455.CrossRefGoogle Scholar
Gomez, A., Conde, A., Aguiar, J.A., Santana, J.M., Jorrin, A., Betancor, P.Diagnostic usefulness of carbohydrate-deficient transferrin for detecting alcohol-related problems in hospitalized patients. Alcohol Alcohol 2001;36:266–270.CrossRefGoogle ScholarPubMed
Hammer, T., Vaglum, P.Users and nonusers within a high risk milieu of cannabis use. A general population study. Int J Addict 1991;26:595–604.CrossRefGoogle ScholarPubMed
Harasymiw, J., Bean, P.The combined use of the early detection of alcohol consumption (EDAC) test and carbohydrate-deficient transferrin to identify heavy drinking behaviour in males. Alcohol Alcohol 2001;36:349–353.CrossRefGoogle ScholarPubMed
Kandel, D.B., Johnson, J.G., Bird, H.R., Weissman, M.M., Goodman, S.H., Lahey, B.B.Psychiatric comorbidity among adolescents with substance use disorders: findings from the MECA study. J Am Acad Child Adolesc Psychiatry 1999;38:693–699.CrossRefGoogle ScholarPubMed
Kessler, R.C., Crum, R.M., Warner, L.A., Nelson, C.B., Schulenberg, J., Anthony, J.C.Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Arch Gen Psychiatry 1997;54:313–321.CrossRefGoogle ScholarPubMed
Laatikainen, T., Alho, H., Vartiainen, E., Jousilahti, P., Sillanaukee, P., Puska, P.Self-reported alcohol consumption and association to carbohydrate-deficient transferrin and gamma-glutamyltransferase in a random sample of the general population in the Republic of Karelia, Russia and in the North Karelia, Finland. Alcohol Alcohol 2002;37:282–288.CrossRefGoogle Scholar
Lynskey, M., White, V., Hill, D., Letcher, T., Hall, W.Prevalence of illicit drug use among youth: results from the Australian School Students’ Alcohol and Drugs Survey. Aust N Z J Public Health 1999;23:519–524.CrossRefGoogle ScholarPubMed
Mathers, D.C., Ghodse, A.H.Cannabis and psychotic illness. Br J Psychiatry 1992;161:648–653.CrossRefGoogle ScholarPubMed
McCreadie, R.G., Scottish Comorbidity Study Group Use of drugs, alcohol and tobacco by people with schizophrenia: case-control study. Br J Psychiatry 2002;181:321–325.CrossRefGoogle ScholarPubMed
Mieczkowski, T., Barzelay, D., Gropper, B., Wish, E.Concordance of three measures of cocaine use in an arrestee population: Hair, urine, and self-report. J Psychoactive Drugs 1991;23:241–249.CrossRefGoogle Scholar
Montalto, N.J., Bean, P.Use of contemporary biomarkers in the detection of chronic alcohol use. Med Sci Monit 2003;9:RA285–RA290.Google ScholarPubMed
Ogborne, A.C., Smart, R.G.Cannabis users in the general Canadian population. Subst Use Misuse 2000;35:301–311.CrossRefGoogle ScholarPubMed
Onyango, R.S.Cannabis psychosis in young psychiatric inpatients. Br J Addiction 1986;81:419–423.CrossRefGoogle ScholarPubMed
Patton, G.C., Hibbert, M., Rosier, M.J., Carlin, J.B., Caust, J., Bowes, G.Patterns of common drug use in teenagers. Aust J Public Health 1995;19:393–399.CrossRefGoogle ScholarPubMed
Regier, D.A., Farmer, M.E., Rae, D.S., Locke, B.Z., Keith, S.J., Judd, L.L.et al.Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990;264:2511–2518.CrossRefGoogle ScholarPubMed
Robertson, J.R., Miller, P., Anderson, R.Cannabis use in the community. Br J Gen Practice 1996;46:671–674.Google Scholar
Schwan, R., Loiseaux, M.N., Schellenberg, F., Albuisson, E., Favre, J.D., Rigaud, A.et al.Multicenter validation study of the %CDT TIA kit in alcohol abuse and alcohol dependence. Alcohol Clin Exp Res 2004;28:1331–1337.CrossRefGoogle ScholarPubMed
Sillanaukee, P., Aalto, M., Seppa, K.Carbohydrate-deficient transferrin and conventional alcohol markers as indicators for brief intervention among heavy drinkers in primary health care. Alcohol Clin Exp Res 1998;22:892–896.CrossRefGoogle ScholarPubMed
Sitharthan, T., Singh, S., Kranitis, P., Currie, J., Freeman, P., Murugesan, G.Integrated drug and alcohol intervention: development of an opportunistic intervention program to reduce alcohol and other substance use among psychiatric patients. Aust N Z J Psychiatry 1999;33:676–683.CrossRefGoogle ScholarPubMed
Stowell, L., Stowell, A., Garrett, N., Robinson, G.Comparison of serum β-hexosaminidase isoenzyme β activity with serum carbohydrate-deficient transferrin and other markers of alcohol abuse. Alcohol Alcohol 1997;32:703–714.CrossRefGoogle ScholarPubMed
Test, M.A., Wallisch, L.S., Allness, D.J., Ripp, K.Substance abuse in young adults with schizophrenic disorders. Schizophr Bull 1989;14:73–81.Google Scholar
Tonnesen, H., Carstensen, M., Maina, P.Is carbohydrate-deficient transferrin a useful marker of harmful alcohol intake among surgical patients?. Eur J Surgery 1999;165:522–527.Google ScholarPubMed
Weinberg, N.Z., Rahdert, E., Colliver, J.D., Glantz, M.D.Adolescent substance abuse: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1998;37:252–261.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.