Substance Abuse Disorders: Psychiatric Trainees' Knowledge, Diagnostic Skills and Attitudes

Objective: The drug and alcohol related knowledge and attitudes of trainee psychiatrists were examined to obtain a baseline measure of these factors in order to determine whether current training is appropriate and adequate.Method: A questionnaire was distributed to trainees enrolled in the training program of the Royal Australian and New Zealand College of Psychiatrists in New South Wales, Victoria, Queensland and South Australia (N=425). Questions were asked relating to theoretical knowledge, diagnostic and problem solving skills for a number of drug groups; further questions concerned the respondents' attitudes and opinions on aspects of management.Results: Sixty per cent of recipients returned the questionnaire. Theoretical and applied knowledge levels were of an adequate standard overall, but highly variable. Notable areas of weakness included knowledge of opiates, barbiturates and stimulants. Trainees' views regarding treatment options were also variable. Alcoholics Anonymous was considered the best supported form of treatment from evidence from controlled trials. Low levels of self efficacy and little support were recognised for early intervention strategies.Conclusions: While positive views were generally expressed towards involvement with patients with alcohol and drug problems, specific strategies to enhance training and performance are needed. Findings are discussed in terms of continuing education. It is recommended that if sufficient training in this area is not provided then psychiatrists will have little confidence in appropriate therapeutic approaches in treating substance misusers.