Abstract Objective: This study aimed to assess the validity of the psychiatric problems subscale of the Addiction Severity Index (ASI-psych) to ascertain psychiatric comorbidity among individuals participating in randomized controlled trials (RCTs) of substance use disorder (SUD) treatments. Methods: The ASI-psych score among 1,660 RCT participants of National Institute of Drug Abuse Clinical Trials Network studies was compared against diagnosis of any serious mental disorder based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (SCID) or Mini-International Neuropsychiatric Interview (MINI). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for detecting any serious mental disorders were estimated by the receiver operating characteristic (ROC) analysis. Results: Based on the overall sample, the AUC score for any serious mental disorder was 0.72 (95% confidence interval [CI], [0.69, 0.75]) with the optimal ASI-psych score of 24.6. There was no statistically significant difference in AUCs based on the SCID and MINI (χ2 = 0.05, p = .82) or by target drugs of RCTs (χ2 =1.33, p = .72). Conclusions: Results support the utility of the ASI in screening for psychiatric comorbidity among patients receiving SUD treatments in RCT settings.

中文翻译：

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在多中心随机对照试验中验证成瘾严重程度指数 (ASI) 用于评估精神病共病

摘要 目的：本研究旨在评估成瘾严重程度指数 (ASI-psych) 的精神问题分量表的有效性，以确定参与物质使用障碍 (SUD) 治疗的随机对照试验 (RCT) 的个体的精神共病。方法：根据精神疾病诊断和统计手册第四版 (SCID) 的结构化临床访谈，将美国国家药物滥用研究所临床试验网络研究的 1,660 名 RCT 参与者的 ASI-psych 评分与任何严重精神障碍的诊断进行比较或迷你国际神经精神病学访谈（MINI）。敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、用于检测任何严重精神障碍的曲线下面积 (AUC) 是通过受试者工作特征 (ROC) 分析估计的。结果：基于总体样本，任何严重精神障碍的 AUC 评分为 0.72（95% 置信区间 [CI]，[0.69, 0.75]），最佳 ASI-psych 评分为 24.6。基于SCID和MINI（χ2 = 0.05，p = .82）或RCT的靶药物（χ2 = 1.33，p = .72），AUCs没有统计学显着差异。结论：结果支持 ASI 在 RCT 环境中接受 SUD 治疗的患者中筛查精神共病的效用。基于SCID和MINI（χ2 = 0.05，p = .82）或RCT的靶药物（χ2 = 1.33，p = .72），AUCs没有统计学显着差异。结论：结果支持 ASI 在 RCT 环境中接受 SUD 治疗的患者中筛查精神共病的效用。基于SCID和MINI（χ2 = 0.05，p = .82）或RCT的靶药物（χ2 = 1.33，p = .72），AUCs没有统计学显着差异。结论：结果支持 ASI 在 RCT 环境中接受 SUD 治疗的患者中筛查精神共病的效用。