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Drinking problem: a hidden problem in general practice

S Assanangkornchai1

  • 1Department of Psychiatry, Faculty of Medicine, Prince of Songkhla University Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|May 1, 1993
PubMed
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This study found that 7.5% of general practice patients were problem drinkers. The SMAST screening tool showed moderate accuracy in detection, while the CAGE questionnaire had low sensitivity and specificity.

Area of Science:

  • General Practice
  • Psychiatry
  • Screening Tools

Background:

  • Alcohol misuse is a significant public health concern.
  • Early detection of problem drinking in primary care settings is crucial.
  • Validated screening tools are needed to identify at-risk individuals.

Purpose of the Study:

  • To determine the prevalence of problem drinking in a general practice population.
  • To evaluate the diagnostic accuracy of the SMAST (Short Michigan Alcoholism Screening Test) and CAGE (Cut down, Annoyed, Guilty, Eye-opener) questionnaires.
  • To assess the reliability and validity of these screening tools.

Main Methods:

  • A cross-sectional study involving 320 general practice patients.
  • Psychiatric interview used as the gold standard for diagnosing problem drinking.

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  • Test-retest method to assess the reliability of SMAST and CAGE.
  • Concurrent validity assessed by comparing questionnaire results with psychiatric diagnosis.

    • Main Results:

    • Problem drinkers were identified in 7.5% of the study population.
    • SMAST demonstrated substantial reliability and repeatability.
    • At a cutoff of >= 3, SMAST showed 68% sensitivity and 77.8% specificity.
    • The CAGE questionnaire exhibited low sensitivity and specificity.

    Conclusions:

    • The SMAST is a reasonably effective tool for screening problem drinkers in general practice.
    • The CAGE questionnaire appears less suitable for this population due to its low diagnostic accuracy.
    • Further research may be needed to refine screening strategies for alcohol misuse in primary care.