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Understanding Discrepancies in the Prediction of Mental Health, Substance Use and Dual Disorders. Implications From a Multi-Site International Study

Published online by Cambridge University Press:  23 March 2020

R. Carmona Camacho ,
L. Chavez ,
A. Villar ,
C. Vidal ,
R. Polo ,
E. Baca-García  and
M. Alegria
R. Carmona Camacho*
Affiliation:
IIS- Fundacion Jiménez Díaz, department of psychiatry, Madrid, Spain
L. Chavez
Affiliation:
University of Puerto Rico medical sciences campus, behavioral sciences research institute, San Juan, Puerto Rico
A. Villar
Affiliation:
Vall d’Hebron university hospital, Universidad Autónoma de Barcelona, department of psychiatry and forensic medicine, Barcelona, Spain
C. Vidal
Affiliation:
IIS- Fundacion Jiménez Díaz, department of psychiatry, Madrid, Spain
R. Polo
Affiliation:
IIS- Fundacion Jiménez Díaz, department of psychiatry, Madrid, Spain
E. Baca-García
Affiliation:
IIS- Fundacion Jiménez Díaz, department of psychiatry, Madrid, Spain
M. Alegria
Affiliation:
Massachusetts general hospital and Harvard medical school, department of psychiatry, disparities research unit, department of medicine, Boston, USA
*
* Corresponding author.

Abstract

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Introduction

The use of valid and practical screening scales might ease the burden for greatly needed universal testing for mental health, substance use and dual disorders, but do they work well with all populations? Do they miss correct identification of certain groups?

Objective

To understand discrepancies in diagnostic prediction using the AC-OK screen in conjunction with other standardized assessment scales.

Methods

Two hundred and twenty-six Latino participants were recruited from primary care and community clinics in Madrid, Barcelona and Boston and assessed with standardized mental health and substance abuse measures including the AC-OK screen and with a Computerized adaptive test for mental health (CAT-MH). A measure of frequency of discrepancies and an adjusted and unadjusted comparison of results and demographic characteristics or respondents were made for mental health, substance abuse or for discrepancies in both categories.

Results

35.4% of cases were discrepant in mental health (AC-OK-Mental Health vs. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7 or PTSD Checklist) and 14.2% in substance abuse (AC-OK-substance abuse vs. drug abuse screening test or Alcohol use disorders identification test). When CAT-MH scale was incorporated, discrepant results were found in 24.3% and 14.2%, respectively. No association was found between substance abuse discrepancies and patient demographics. In logit regressions being from Barcelona, of younger age and male were significant predictors of discrepancies.

Conclusions

Discrepancies were observed in the diagnostic prediction, with differences detected for site and sociodemographic characteristics of participants suggesting the importance of testing screeners for site and population differences. Evidence for the misclassification of young males is discussed. Caution is warranted in the implementation of screeners for at risk populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV919
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S515
Copyright
Copyright © European Psychiatric Association 2016
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