Differences in what happens after you screen positive for depression versus hazardous alcohol use

The success of any secondary prevention effort in identifying those in need for further services depends on the primary care team following all positive screening results with additional assessment or intervention. Initial research suggests possible differences in primary care responses to positive screens for hazardous alcohol use compared to depression. Therefore, the purpose of this study was to examine current practices of Veterans Affairs healthcare providers following a positive screen for hazardous alcohol use or depression. Chart reviews were conducted for a random sample of 98 Veterans who screened positive for hazardous alcohol use using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questions and a separate sample of 99 Veterans who screened positive for depression using the 2-item Patient Health Questionnaire (PHQ-2) over a 1-year period. Findings suggest multiple discrepancies in screening practices between the AUDIT-C and the PHQ-2. These include a higher likelihood of further depression assessment or referral after a positive PHQ-2 screen. Scores on the AUDIT-C that indicate heavier alcohol consumption were more likely to result in assessment or intervention than did lower but still positive AUDIT-C scores. Overall, these data suggest that many opportunities are missed, especially in regards to hazardous alcohol use, for prevention and intervention.