|Validitšt von cannabisbezogenen Diagnosen in Suchtberatu ...|
Simon, R. & Kraus, L. (2007). Validitšt von cannabisbezogenen Diagnosen in Suchtberatungsstellen [Validity of cannabis-related diagnoses in addiction counselling centres]. Sucht, 53 (5), 308-314.
|Background: Providing diagnoses in out-patient counselling centres for addicts mainly through social workers has been questioned repeatedly. For this reason the validity of cannabis related diagnoses (ICD-10: harmful use and dependence syndrome) have been assessed as part of the German Addiction Aid Statistics (DSHS). Consequently it has been analysed, if the number of cannabis related disorders reported by the German Addiction Aid Statistics has to be corrected. In addition, further diagnoses for this group of clients are reported.|
Method: In the study on Cannabis Related Disorders (CARED) a random sample of 52 out-patient facilities has been selected. Within these facilities n=86 clients with primary cannabis related disorders who had been in treatment between December 2002 und December 2003 were diagnosed using computerized clinical interviews (CIDI). The validation diagnoses were compared to the DSHS routine diagnoses.
Results: Validation diagnoses found a cannabis related disorder with clinical relevance in 74.4% of all cases. Diagnoses of dependence were congruent in 64,9% of the cases and diagnoses of harmul use in 12,0% of the cases. If misclassifications are taken into account, about 17,400 individuals were estimated to enter treatment for primary cannabis related disorders in 2005. The majority of cannabis clients (63.9%) received no other diagnoses, 23.0% an additional alcohol disorder. Other psychological diagnoses found in this client group were affective disorders (31%), anxiety (18%), and psychoses (18%).
Conclusions: The application of ICD-10 in basis documentation turned out to be workable. Differentiation between dependence and harmful use showed low validity. The quality of diagnoses should be improved through an extension of the classification system through sub-clinical categories of disorders and training of staff. The aid system, which has been focussed on heavily addicted heroin users over decades has to adjust more and more to this group in order to offer adequate services for these young clients.