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Substance use history taking by trainee psychiatrists: “There is a tide in the affairs of men…”

Published online by Cambridge University Press:  13 June 2014

Alistair Grandison ,
Hugh Williams ,
Adenekan Oyefeso  and
Luiz Dratcu
Alistair Grandison
Affiliation:
South London and Maudsley NHS Trust, York Clinic, Guy's Hospital, London SE1 3RR, England
Hugh Williams
Affiliation:
Substance Misuse Service, South Downs Health NHS Trust, 26 Ditchling Rd, Brighton BN1 4SF andDepartment of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London SW17 ORE, England
Adenekan Oyefeso
Affiliation:
Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London SW17 ORE, England
Luiz Dratcu
Affiliation:
South London and Maudsley NHS Trust, York Clinic, Guy's Hospital, London SE1 3RR, Senior Lecturer, Joint Division of Psychiatry and Psychology, GKT, Guy's Hospital, London SE1 3RR, England
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Abstract

Objectives: To investigate the extent and quality of substance use history taking by trainee psychiatrists.

Method: A retrospective clinical casenote audit of admissions to an acute inner city psychiatric unit during three randomly selected months. Data on substance use history taking was recorded by means of a specially designed study checklist.

Results: In almost three-quarters (45, 73%) of admission episodes trainee psychiatrists had made some mention of substance misuse. However, substance use history taking often occurred subsequent to the initial clinical assessment and varied greatly in quality.

Conclusions: The need for a brief, standardised substance use screening questionnaire, easily incorporated into the existing psychiatric interview format is highlighted.

Keywords

Psychiatric assessmentSubstance misuseDual diagnosisTrainee psychiatrists.
Type
Audits
Information
Irish Journal of Psychological Medicine , Volume 18 , Issue 1 , March 2001 , pp. 24 - 26
Copyright
Copyright © Cambridge University Press 2001

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References

1.Audini, B, Duffett, R, Lelliot, P, Pearce, A, Ayres, C. Over-occupancy in London's acute psychiatric units – fact or fiction? Psychiat Bulletin 1999; 23: 590–4.CrossRefGoogle Scholar
2.El Guebaly, N. Substance abuse and mental disorders: the dual diagnosis concept. Can J Psychiat 1990; 35: 261–7.CrossRefGoogle Scholar
3.Hall, W, Farrell, M. Co-morbidity of mental disorders with substance misuse Br J Psychiat 1997; 171: 4–5.CrossRefGoogle ScholarPubMed
4.Williams, H. Dual diagnosis: fact or fiction for the practising clinician? lr J Psych Med 1998; 15(1): 3–5.Google Scholar
5.Ramsey, RM, Partridge, S, Byron, C. Drug misuse declared in 1998. results from the British Crime Survey. Home Office Research Study No 93, London: Home Office,1999.Google Scholar
6.Addington, J, Addington, D. Effect of substance misuse in early psychosis. Br J Psychiat 1998; 172 (Supp. 33): 134–6.CrossRefGoogle ScholarPubMed
7.Cohen, SI. Over-diagnosis of schizophrenia: role of alcohol and drug misuse. Lancet 1995; 346: 1541–2.CrossRefGoogle ScholarPubMed
8.Cantwell, R, Brewin, J, Glazebrook, C, Dalkin, T, Fox, R, Medley, I, Harrison, G. Prevalence of substance misuse in first – episode psychosis. Br J Psychiat 1999; 174: 150–3.CrossRefGoogle ScholarPubMed
9.McGuire, PK, Jones, P, Harvey, I, Bebbington, P, Toone, B, Lewis, S, Murray, RM. Cannabis and acute psvchosis. Schizophrenia Research 1994; 13: 161–8.CrossRefGoogle Scholar
10.Sokolshi, KN, Cummings, JL, Abrams, BI, DeMet, EM, Kalz, LS, Costa, JF. Effects of substance misuse on hallucination rates and treatment response in chronic psychiatric patients. J Clinical Psychiat 1994; 55: 380–7.Google Scholar
11.Pristach, CA, Smith, CM. Medication compliance and substance abuse among schizophrenic patients. Hospital Community Psychiat 1990; 41: 1345–8.Google ScholarPubMed
12.Poole, R, Brabbins, C. Drug induced psychosis. Br J Psychiat 1996; 168; 135–8.CrossRefGoogle ScholarPubMed
13.Gupta, S, Hendricks, S, Kenkel, AM, Bhatia, SC, Haffke, EA. Relapse in schizophrenia: is there a relationship to substance misuse? Schizophrenia Research 1996; 20: 153–6.CrossRefGoogle Scholar
14.Farrell, M, David, A. Do psychiatric registrars take a proper drinking history? BMJ 1988; 296: 395–6.CrossRefGoogle Scholar
15.Taylor, SJ. Changes in alcohol history taking by psychiatric junior doctors: an audit. Ir J Psych Medicine 1995; 12(1): 36–7.Google Scholar
16.Crome, I. Substance misuse and psychiatric comorbidity: towards improved service provision. Drugs: education, prevention and policy 1999; 6(2): 151–74.Google Scholar
17.Ghodse, AH. Drug History. In: Drugs and addictive behaviour: a guide to treatment. Hamid Ghodse. Oxford: Blackwell Science, 1995.Google Scholar
18.Department of Health. Assessment. In: Drug misuse and dependence: guidelines on clinical management. London: HMSO, 1999.Google Scholar
19.Wallace, P, Haines, A. Use of a questionnaire in general practice to increase the recognition of patients with excessive alcohol consumption. BMJ 1985; 290: 1949–52.CrossRefGoogle ScholarPubMed