Michigan Alcoholism Screening Test to diagnose early alcoholism in a general practice

General medical patients can be easily screened for alcohol dependence on a routine basis. The Michigan Alcoholism Screening Test (MAST) is a 24-item yes-no questionnaire concerning alcohol-related behavior. When it was included in the history self-administered to new patients in an internal medicine faculty-resident outpatient practice, it uncovered unsuspected alcohol dependence. The combined questionnaire (health history plus MAST) was given to 351 consecutive new outpatients. Thirteen (4%) were found to have positive MAST scores (greater than 7), indicating alcohol dependence. Nine patients were in the mild dependence range (7 to 20), two in the moderate range (20 to 30), and two in the severe range (30 to 53). All patients with significant MAST scores had complaints related to active drinking. The MAST score directed the physicians' therapeutic efforts in nine of 13 patients; in four the significant MAST score was ignored. The MAST is useful to detect unsuspected alcohol dependence in office practice. When used by faculty and residents trained in recognizing alcohol-related behavior, the test will properly direct therapeutic and rehabilitative efforts for those patients with the primary diagnosis of alcohol dependence.