The Problem Severity Index (PSI) can be used to evaluate patients who are drug dependent. This can help identify psychosocial problems in the person's life that encourage drug use or that thwart recovery attempts. The authors are from Texas Christian University in Fort Worth.
Components:
(1) multiple drug use (use of any 3 or more drug categories in the past year)
(2) alcohol dependence (by either DSM-III criteria or self-reported daily alcohol consumption)
(3) criminally active (on probation or parole, awaiting trial, case pending, or a period of weekly involvement in illegal activities during the past year)
(4) unemployed (never worked at a full-time job during the past year)
(5) low social support (having several family members or close friends who use illegal drugs, or who were incarcerated during the past year)
(6) depression or anxiety (including suicidal thoughts or acts)
(7) no private insurance
where:
• I would assume that alcohol would be included as one of the drug categories for multiple drug use.
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Problem Status
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Points
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absent
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0
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present
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1
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PSI =
= SUM(points for all 7 components)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score, the greater the number of problems that can reduce the chances of overcoming drug dependence.
• In patients with cocaine dependence, a low level of problems was associated with a lower relapse rates. A person with a high problem level often benefited from a long term residential recovery program.
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PSI
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Problem Level
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0 to 3
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low
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4 or 5
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medium
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6 or 7
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high
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