Reliability of the Self-Administered Alcoholism Screening Test (SAAST) in psychiatric inpatients

Identification of alcohol abuse in psychiatric patients is essential, since it can confuse the clinical picture and complicate treatment. The utility and reproducibility of the Self-Administered Alcoholism Screening Test (SAAST) was assessed in 236 acutely ill psychiatric patients. Both an initial SAAST given at admission, and a second SAAST given shortly before discharge, were completed by 173 (73%) patients; significant correlation (r = 0.85) was found between scores on SAAST 1 and SAAST 2. Only 41 (17%) patients were unable or refused to complete the initial SAAST and the majority of these received a schizophrenia diagnosis. SAAST scores were also significantly correlated with the clinical assessments and histories. Most (76%) patients with a current or past history of alcohol abuse scored in the "alcoholic" (> or = 8) range on one or both SAASTs. Men were almost twice as likely as women to have a history of alcohol abuse, and significantly more likely to score > or = 8 on the SAAST. The SAAST could be completed by the majority of acutely ill psychiatric patients even at admission, and was clinically useful in the diagnosis of alcohol abuse, especially when used in conjunction with the clinical interview.