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The article presents the report titled "Best Practices for the Treatment of Patients With Mental and Substance Use Illnesses in the Emergency Department," by the Illinois Hospital Association's Behavioral Health Steering Committee Best Practices Task Force. Included in the report are project goals, relevant statistics, current practices, medical assessment, medical clearance, medications, emergency psychiatric evaluation, substance use disorders, psychiatric disorders and safety concerns.

The authors examined the global- and event-level associations between alcohol intoxication and 10 behavioral risks during the 1st year of college. Participants (n = 1113; 62% female; 54% Caucasian) completed 30 days of Web-based self-monitoring that assessed alcohol consumption and involvement in 10 behavioral risks. Generalized estimating equations analyses were used to determine which behaviors covaried with event-level versus global indices of intoxication as well as the moderating effects of gender on the intoxication-behavior associations. Alcohol use was globally related to 8 of the 10 behavioral risks; more important, 5 of the 10 behaviors specifically covaried with daily alcohol intoxication. The differential pattern of associations observed can inform clinical work by identifying groups of students who may most benefit from various intervention approaches and content. [ABSTRACT FROM AUTHOR]

This article is a summary of a symposium presented at the 2005 Research Society on Alcoholism annual conference organized by Dan J. Neal and chaired by William R. Corbin. Event-level data, wherein each “event” (e.g., day) is captured as its own data point, capture the complex patterns of drinking and other high-risk behaviors in ways that the typical aggregate approach cannot. Because of their richness, methodologies that incorporate event-level data are becoming more common in alcohol research. At least 3 distinct forms of event-level data can be gathered: retrospective data (those collected on a single occasion, using memory aids to help each participant reconstruct all drinking events over a specific period of time), daily monitoring data (reporting on all events for that day), and momentary assessment (those recorded immediately following a drinking event or in response to a prompt from researchers). The goal of this symposium was to address many issues associated with event-level methodology, as well as demonstrate projects that are currently implementing such innovative data collection. The 4 presentations included in this symposium were “Realizing the Promise and Avoiding the Pitfalls of Retrospective Daily Estimation Assessments of Alcohol Use” by Frances K. Del Boca; “Using Interactive Voice Response Technology to Assess the Alcohol-Victimization Link” by Kathleen Parks, Linda King, and Ann Pardi; “Methodological Issues in Using Personal Data Assistants to Self-monitor Alcohol Consumption” by R. Lorraine Collins, Mark Muraven, and Charlene Vetter; and “Collecting Event-level Data Using the World Wide Web” by Dan J. Neal and Kim Fromme. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the prevalence and correlates of HIV risk among men receiving treatment for substance abuse in India. Consecutive inpatients from the major substance abuse hospital in southern India were screened using a structured interview and standardized measures to obtain demographic, psychiatric, sexual behavior, and substance use data at the time of admission. Seventy-seven percent of the 352 men who were screened reported that they were sexually active during the past year, and 13% reported that they had engaged in sexual practices associated with greater risk. The most common risk practices in the past year included having multiple sexual partners (7%), paying for sex (5%), and having unprotected anal sex (4%). Engaging in risky sexual practices was associated with the presence of a co-occurring psychiatric disorder and higher scores on a drug abuse screening measure. Assessing HIV risk in substance abuse settings can help to identify patients who may benefit from HIV-risk reduction programs. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To estimate the lifetime prevalence of four sexually transmitted infections (STIs) and to identify correlates of these infections among patients seeking care for a substance use disorder at a specialized DeAddictions Unit in southern India. Methods: Consecutive inpatients (n =361; 98% male; M age=36.7 years) admitted to DeAddictions Unit of the National Institute of Mental Health and Neuro Sciences in Bangalore, India, participated in a structured interview to obtain demographic, psychiatric, sexual behavior, and substance use data; each patient also provided a blood sample for serologic testing for HIV, chlamydia, syphilis, and hepatitis B. Results: One-quarter of all patients tested positive for at least one STI. Lifetime seroprevalence rates were 12.9% for syphilis, 10.3% for chlamydia, 3.1% for hepatitis B, and 1.1% for HIV. Analyses did not reveal any consistent pattern of associations between STI status and sociodemographic, psychiatric, and sexual behavioral characteristics. Conclusions: All patients should receive a comprehensive sexual assessment during standard care; for those patients who report risky sexual practices, we recommend voluntary counseling and testing for STIs. Although we do not recommend universal testing for STIs at this time, this should be revisited based upon national surveillance data. [Copyright &y& Elsevier]

Background: Persons with co-occurring Axis I mental disorders and substance use disorders often experience multiple negative consequences as a result of their substance use. Because no existing measure adequately assesses these population-specific problems, we developed the Problems Assessment for Substance Using Psychiatric Patients (PASUPP). This paper describes the scale development and factor structure, and provides initial reliability and validity evidence for the PASUPP. Methods: An initial pool of 54 items was assembled by reviewing existing measures for relevant items and generating new items. Then, 239 patients (90% male, 61% White) with documented Axis I psychiatric and current substance use disorders rated the lifetime and last 3-month occurrence of each problem, and completed additional measures of substance use and related functioning. Results: Lifetime endorsements ranged from 31 to 95%, whereas 3-month endorsements ranged from 24 to 78%. Item analyses reduced the set to 50 items. The PASUPP is internally consistent (alpha = 0.97) and unidimensional. Scale validity was suggested by moderate correlation with other measures of substance problem severity. Conclusions: Promising psychometric properties are reported for a population-specific measure of substance use problems. Such a measure could be useful for initial assessments and outcome evaluations with substance using psychiatric patients. [Copyright &y& Elsevier]