Validity of Substance Use Self-Reports in Dually Diagnosed Outpatients

OBJECTIVE: The purpose of this study was to assess the validity of self-reports of substance use among outpatients dually diagnosed with substance use disorder and either bipolar disorder or posttraumatic stress disorder. METHOD: Self-reports of substance use were compared with supervised urine samples collected on the same day for 55 subjects. RESULTS: Self-reports were highly valid. Only 4.7% of cases involved subjects not reporting substance use detected by urine screens. CONCLUSIONS: Self-reports of substance use may be highly valid in nonpsychotic, dually diagnosed outpatients under certain conditions, i.e., when patients are in treatment, when urine samples are collected with patients' prior knowledge, when patients are well-known to staff, and when honest self-reporting is encouraged. (Am J Psychiatry 1998; 155:127–128)