Utility of the Self-Administered Alcoholism Screening Test (SAAST) in schizophrenic patients

The utility of the Self-Administered Alcoholism Screening Test (SAAST) in determining alcohol abuse and alcoholism was assessed in a preliminary study of 21 schizophrenic patients during their hospitalization in an acute care psychiatric unit; on admission all met DSM-III-R criteria for schizophrenia and none were detected to have any alcohol-related diagnosis. SAAST scores ranged from 2 to 26 with a mean score of 10.8. Forty-eight percent (10/21) had SAAST scores greater than or equal to 10, indicating "probable alcoholism"; 62% (13/21) scored 8 or higher. Every patient with a SAAST score of 8 or higher also met DSM-III-R criteria for alcohol abuse or dependence on the basis of patient interview, independent chart reviews, and interviews of significant others. In contrast, only half (5/10) of the high SAAST scorers would actually admit to a problem with drinking during the extensive study interviews. Six SAAST items were found to be highly predictive of abuse or alcoholism; the SAAST had greater sensitivity than the interviews. Sixty-two percent (8 of 13) of the schizophrenic patients who met the DSM-III-R criteria for alcohol abuse reported a first degree relative with an alcohol-related problem, in contrast to only 25% of the "nonalcoholic" patients. The patterns of the alcoholic schizophrenic patients' responses on the different SAAST items revealed even greater denial and lack of insight than those of nonschizophrenic alcoholic subjects.