The MacAndrew Scale: clinical application and theoretical issues

The research literature on the MacAndrew (MAC) Scale was surveyed to identify factors that influence the scale's usefulness as a screening device for alcohol misuse, and to explore the meaning of MAC Scale scores. Although the MAC Scale's ability to discriminate alcoholic and substance misuse groups from nonalcoholic psychiatric groups is well documented, the scale may not discriminate between alcoholics and antisocial individuals, or between patients with combined alcoholic psychiatric diagnoses and nonalcoholic psychiatric patients. Recommendations for future research and for the clinical application of the MAC Scale are provided.