Validity of self-reported psychiatric diagnoses among patients seeking treatment for a substance use disorder

Patients seeking treatment for substance use disorders (SUDs) frequently report a history of psychiatric diagnoses, but the validity of these diagnoses is not well established. The study aimed to validate self-reported historical mental diagnoses in patients with an SUD using psychometric tests and structured interviews. This cross-sectional study of participants (n = 30) with an SUD compared their self-reported prior psychiatric diagnoses with current clinical diagnoses based on psychometric tests and structured psychosocial interviews. Of the 11 participants reporting a prior diagnosis of bipolar disorder (BD), only one received a current clinical diagnosis of BD. The historical diagnosis of a personality disorder was confirmed in the two participants reporting this diagnosis, and 15 new diagnoses were made. Bipolar disorder was over-diagnosed in participants with an SUD who instead might have personality disorders. Self-reported psychiatric diagnoses presented by patients for treatment of an SUD should be validated using psychometric tests and medications should be re-evaluated. We recommend that all patients with an SUD be screened for Axis I and II psychiatric diagnoses.