Dhossche D M
Department of Psychiatry, University of South Alabama, Mobile 36617-2293, USA.
Am J Forensic Med Pathol. 2000 Dec;21(4):330-4. doi: 10.1097/00000433-200012000-00006.
To assess the role of toxicologic detection of alcohol to diagnose substance abuse disorders in suicides, the author reviewed suicide studies with both comprehensive toxicologic and diagnostic data. The sensitivity of alcohol detection to diagnose alcohol and substance abuse disorders in suicides was low in all studies (range, 39%-42%), and the specificity was 80%-95%. A higher cutoff level for alcohol did not increase diagnostic performance. The author concludes that toxicologic detection of alcohol is not a reliable indicator of alcohol and substance abuse disorders in suicides because of the high rate of false-negatives. Most of the suicides with positive alcohol detection seem to suffer from chronic substance abuse problems. The role of intoxication is difficult to assess because of methodologic problems.
为评估酒精的毒理学检测在自杀者物质使用障碍诊断中的作用，作者回顾了同时具备全面毒理学和诊断数据的自杀研究。在所有研究中，酒精检测用于诊断自杀者酒精及物质使用障碍的敏感性较低（范围为39% - 42%），特异性为80% - 95%。提高酒精的截断水平并不能提升诊断性能。作者得出结论，由于假阴性率较高，酒精的毒理学检测并非自杀者酒精及物质使用障碍的可靠指标。大多数酒精检测呈阳性的自杀者似乎患有慢性物质滥用问题。由于方法学问题，中毒的作用难以评估。
