Nicola Garzotto

Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study

Abstract Objective: To determine the properties of the alcohol use disorders identification test in screening primary care attenders for alcohol problems. Design: A validity study among consecutive primary care attenders aged 18-65 years. Every third subject completed the alcohol use disorders identification test (a 10 item self report questionnaire on alcohol intake and related problems) and was interviewed by an investigator with the composite international diagnostic interview alcohol use module (a standardised interview for the independent assessment of alcohol intake and related disorders). Setting: 10 primary care clinics in Verona, north eastern Italy. Patients: 500 subjects were approached and 482 (96.4%) completed evaluation. Results: When the alcohol use disorders identification test was used to detect subjects with alcohol problems the area under the receiver operating characteristic curve was 0.95. The cut off score of 5 was associated with a sensitivity of 0.84, a specificity of 0.90, and a positive predictive value of 0.60. The screening ability of the total score derived from summing the responses to the five items minimising the probability of misclassification between subjects with and without alcohol problems provided an area under the receiver operating characteristic curve of 0.93. A score of 5 or more on the five items was associated with a sensitivity of 0.79, a specificity of 0.95, and a positive predictive value of 0.73. Conclusions: The alcohol use disorders identification test performs well in detecting subjects with formal alcohol disorders and those with hazardous alcohol intake. Using five of the 10 items on the questionnaire gives reasonable accuracy, and these are recommended as questions of choice to screen patients for alcohol problems.

Reported prevalence of alcohol dependence in South-Verona: A case register study

Abstract In this study all patients who received from 1979 to 1982 the diagnosis of “alcohol dependence” have been selected from the South-Verona Psychiatric Case Register. The register area coincides with the health care area of a well-integrated community psychiatric Service, set up in 1978 under the new Italian Mental Health Act. The reported prevalence rates of alcoholic patients decreased in this 4-year period, this decrease being due mainly to the diminuition of male patients contacting a psychiatric agency. Age- and sex-specific prevalence rates are reported, as are patterns of inpatient and out-patient care and 1-year inception rates. Within the overall reported prevalence the ratio between patients who received community care only and those who had also or only inpatient care shows that about half of alcoholic patients contacting a psychiatric agency receive out-patient care only.