Biomedical subjects
Publications and source records attributed to E Corty.
The test-retest reliability of three measures used in cigarette smoking research was assessed over a two week period. In terms of either shifts in the mean from time 1 to time 2, or a low correlation between time 1 and time 2, or a change in internal consistency from time 1 to time 2, none of the measures was considered adequately reliable.
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Studies of patients admitted to public mental hospitals have consistently found high rates of comorbid substance use disorders. We sought a better understanding of this comorbidity among psychiatric inpatients, in particular differentiating two groups of "dual diagnosis" patients, (1) those with independent mental disorders complicated by substance use disorders, and (2) those with psychoactive substance use disorder-induced organic mental disorders (PSUD-induced OMD). The diagnoses of 435 consecutively admitted inpatients from an inner-city catchment area were ascertained with the Structured Clinical Interview for DSM-III-R (1987 Inpatient Version [SCID-P]), modified to describe more accurately the relationships between psychiatric syndromes and substance use. More than half (55.9%) of these psychiatric patients had current substance use disorders. Over half (53.6%) of these "dually diagnosed" patients had no lifetime history of an independent mental disorder, but rather had psychiatric syndromes related to psychoactive substance use. The dual diagnosis subgroups differed on treatment history, principal psychiatric diagnoses, and the types of substances used. The results underscore the heterogeneity of dual diagnosis patients admitted to psychiatric hospitals and the potential importance of differentiating among these subgroups.
The present paper examines the limitations that are placed on our understanding of addiction when research is restricted to studying opiate users who are seeking treatment. Though users who do seek treatment do not seem to differ in terms of their history or magnitude of drug use from those not seeking treatment, those in treatment are likely to have more serious addiction-related problems. Addicts who seek different types of treatment (e.g., methadone maintenance vs therapeutic community) appear to differ in terms of social and psychological characteristics. However, specific characteristics do not appear to be matched with specific treatments. Thus the addicts seen in treatment in general or in any specific treatment represent a discrete subpopulation of the entire population of opiate users. As such, any generalizations that we make about addiction based on these addicts must be limited.