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Detection of alcohol consumption in suicides
Barbara Schneider1, Axel Schnabel, Dieter Sargk
1Center of Psychiatry, Dept. of Psychiatry & Psychotherapy, Johann Wolfgang Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany.
European Archives of Psychiatry and Clinical Neuroscience
|November 19, 2004
Summary
The Luebeck Alcohol Dependence and Abuse Screening Test (LAST) is a reliable tool for identifying alcohol abuse and dependence in psychological autopsy studies. This validated screening instrument demonstrates high accuracy and can be recommended for postmortem research.
Area of Science:
- Psychiatry
- Forensic Psychology
- Addiction Medicine
Background:
- Psychological autopsy studies require validated instruments for assessing alcohol use disorders.
- Existing screening tools for alcohol consumption, abuse, and dependence lack validation for this specific research design.
Purpose of the Study:
- To investigate the interrater and test-retest reliability of the Luebeck Alcohol Dependence and Abuse Screening Test (LAST).
- To assess the usability of the LAST for the psychological autopsy method.
- To validate the LAST for identifying alcohol abuse and dependence in completed suicides and population-based controls.
Main Methods:
- A case-control study involving 163 completed suicides and 396 population-based controls.
- Alcohol consumption assessed using semi-structured interviews, including the Structured Clinical Interview for DSM-IV Axis I (SCID-I) and the LAST.
- Informant interviews were used to assess reliability, with results compared to personal interviews.
Main Results:
- The LAST demonstrated high sensitivity and specificity for detecting alcohol abuse and dependence in both controls and suicide cases.
- LAST scores were significantly associated with high, frequent, and hazardous alcohol consumption in suicide victims.
- Comparison of personal and informant interviews yielded a high Spearman correlation coefficient (0.74), supporting reliability.
Conclusions:
- The LAST is a reliable and valid instrument for identifying individuals with alcohol dependence and abuse using the best-estimate method.
- The 7-item version of the LAST is recommended as a useful tool for psychological autopsy procedures in postmortem research.
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