Drug screens for psychiatric patients in the emergency department: evaluation and recommendations

Psychosomatics. Jan-Feb 2013;54(1):60-6. doi: 10.1016/j.psym.2012.08.007. Epub 2012 Nov 27.


Objective: To better understand how toxicology screening for psychiatric patients in the emergency department (ED) setting affects diagnostic decisions.

Methods: Retrospective chart review of 439 ED visits of adult patients receiving psychiatry consultations at two hospitals, one an academic medical center (n =224) and the other a community hospital (n = 220), between July 2008 and February 2009. Clinical, demographic, and ED length of stay (LOS) information was abstracted from the psychiatry consultation notes and the medical records.

Results: Positive urine toxicology results, when combined with a basic substance abuse history, were not associated independently with a patient's receiving a substance-related diagnosis as part of the psychiatric assessment. By contrast, a positive blood alcohol level was associated independently with a patient's receiving one of these diagnoses while a positive alcohol use history was not.

Conclusions: Urine toxicology screens do not add significant diagnostic value to all ED psychiatric evaluations when combined with standard substance use histories.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol-Related Disorders / diagnosis
  • Alcohol-Related Disorders / psychology
  • Emergency Service, Hospital / statistics & numerical data
  • Emergency Services, Psychiatric / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Middle Aged
  • Retrospective Studies
  • Substance Abuse Detection / statistics & numerical data*
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / psychology