Journal Articles
Abstract:
Background: Substance abuse (SA) and mental
illness (MI) commonly co-occur with HIV
infection in the United States and have
important implications for clinical
management of HIV/AIDS. Yet SA/MI often go
untreated due in part to a lack of practical,
validated screening tools.
Setting: HIV clinic in academic medical center.
Methods: The 16-item SA/MI Symptoms Screener
(SAMISS) targets SA/MI in HIV-positive
patients. Consecutive consenting HIV-positive
patients completed the SAMISS and then a
reference standard diagnostic tool, SCID, the
Structured Clinical Interview for DSM-IV
(Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition).
Results: Twenty percent of participants
(29/148) had an SA diagnosis and 41% (59/143)
had an MI diagnosis in the past year on the
SCID; 48% (68/143) had 1 or both.
Thirty-seven percent (55/148) screened
positive for SA and 69% (99/143) screened
positive for MI on the SAMISS. The SAMISS had
86% (95% CI: 68%-96%) sensitivity and 75%
(66%-82%) specificity for SA and 95%
(86%-99%) sensitivity and 49% (38%-60%)
specificity for MI. Patients with SA were
likely to show up as false positives for MI
and vice versa.
Conclusion: The SAMISS functioned well as a
first-line screening tool for SA/MI in this
HIV clinic population. It missed few cases
and was easily incorporated into a busy
clinical setting. Persons screening positive
require a more rigorous confirmatory
psychiatric evaluation.

Sanford Building