Assessing illicit drug use among adults with schizophrenia.

Accurate drug use assessment is vital to understanding the prevalence, course, treatment needs, and outcomes among individuals with schizophrenia because they are thought to remain at long-term risk for negative drug use outcomes, even in the absence of drug use disorder. This study evaluated self-report and biological measures for assessing illicit drug use in the Clinical Antipsychotic Trials of Intervention Effectiveness study (N=1460). Performance was good across assessment methods, but differed as a function of drug type, measure, and race. With the Structured Clinical Interview for DSM-III-R as the criterion, self-report evidenced greater concordance, accuracy and agreement overall, and for marijuana, cocaine, and stimulants specifically, than did urinalysis and hair assays, whereas biological measures outperformed self-report for detection of opiates. Performance of the biological measures was better when self-report was the criterion, but poorer for black compared white participants. Overall, findings suggest that self-report is able to garner accurate information regarding illicit drug use among adults with schizophrenia. Further work is needed to understand the differential performance of assessment approaches by drug type, overall and as a function of race, in this population.

MMPI-2 profiles of bariatric surgery patients: a replication and extension.

BACKGROUND: Maddi et al. (Obes Surg, 7:397-404, 1997) reported significant elevations on several MMPI-2 scales in a morbidly obese population. Since the number of patients presenting for bariatric surgery has increased significantly in the decade since this study, we replicated the original Maddi et al. study to investigate if there have been any appreciable changes in these patients' psychological profiles within the past 10 years. METHODS: First, we replicated the original Maddi et al. study using the same definition of profile elevations used by these investigators. Second, we extended these findings to include a fourth classification of extremely elevated profiles. Finally, we included several measures of different emotional states/characteristics in an attempt to further delineate what these elevated profiles may actually represent. RESULTS: Our findings generally support the results of the original Maddi et al. study. Additionally, a number of significant relationships were found between our additional measures and MMPI-2 elevations. CONCLUSIONS: Many morbidly obese patients presenting for bariatric surgery have elevated MMPI-2 profiles, some of which would be considered "invalid" profiles. We recommend procedures for obtaining more valid profiles from such patients. We also urge the use of other measures in addition to the MMPI-2 to more specifically clarify the personality traits/characteristics in these patients.