Is the substance abuse of inpatients with schizophrenia overlooked?

The utility of medical records and clinician reports for assessing substance abuse among inpatients with schizophrenia or schizoaffective disorder was assessed in a sample of 296 patients recruited from four general hospitals in New York City. Measures derived from the medical record, the discharge summary, and primary clinician reports are compared to the results of a structured diagnostic interview. Analysis of the sensitivity, specificity, positive predictive value, and overall accuracy of the nondiagnostic sources found unexpectedly high levels of detection. Discharge summaries had the lowest sensitivity when compared to the diagnostic interview, raising concern that inpatient staff and clinicians may fail to communicate substance abuse problems to outpatient providers.