Schneider Barbara, Schnabel Axel, Sargk Dieter, Maurer Konrad, Weber Bernhard, Wetterling Tilman
Center of Psychiatry, Dept. of Psychiatry & Psychotherapy, Johann Wolfgang Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany.
Eur Arch Psychiatry Clin Neurosci. 2005 Feb;255(1):1-5. doi: 10.1007/s00406-004-0524-z. Epub 2004 Nov 19.
Screening instruments for detection of alcohol consumption, abuse, and dependence for use in psychological autopsy studies with case control design are not validated. Therefore, interrater and test-retest reliability of the Luebeck Alcohol Dependence and Abuse Screening Test (LAST) and the usability of this test for the psychological autopsy method were investigated. Alcohol consumption was evaluated by a semi-structured interview including the Structured Clinical Interview for DSM-IV Axis I (SCID-I) and the LAST in 163 completed suicides (mean age 49.6 +/- 19.3 years; 64.4% men) and by personal interview in 396 population-based controls (mean age 51.6 +/- 17.0 years; 55.8% men). Of the controls, 35 were additionally assessed by interviewing informants; these results were compared with those generated by personal interview. Comparison of LAST scores by personal and informant's interview of controls generated a Spearman correlation coefficient of 0.74 (P < 0.0001). The LAST (7 item-version, cut-off of 2) revealed high sensitivity and specificity for alcohol abuse and dependence, in both controls and suicides. LAST scores were significantly associated with high, frequent, and hazardous alcohol consumption (P < 0.001) in suicides. Our findings provide support for reliability and validity of identifying individuals with alcohol dependence and abuse obtained through the best-estimate method using the LAST. This 7-item questionnaire can be recommended as a useful tool for the psychological autopsy procedure in postmortem research.
用于在病例对照设计的心理解剖研究中检测酒精消费、滥用和依赖的筛查工具尚未得到验证。因此，我们对吕贝克酒精依赖与滥用筛查测试（LAST）的评分者间信度和重测信度及其在心理解剖方法中的可用性进行了研究。通过半结构化访谈评估酒精消费情况，该访谈包括《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈（SCID-I）和LAST，共涉及163例已完成自杀者（平均年龄49.6±19.3岁；男性占64.4%），并通过个人访谈评估了396名基于人群的对照者（平均年龄51.6±17.0岁；男性占55.8%）。在对照者中，另外35人通过询问 informant 进行了评估；将这些结果与个人访谈得出的结果进行了比较。对照者个人访谈和 informant 访谈得出的LAST分数比较产生的Spearman相关系数为0.74（P<0.0001）。LAST（7项版本，临界值为2）在对照者和自杀者中对酒精滥用和依赖均显示出高敏感性和特异性。在自杀者中，LAST分数与大量、频繁和危险的酒精消费显著相关（P<0.001）。我们的研究结果支持通过使用LAST的最佳估计方法识别酒精依赖和滥用个体的可靠性和有效性。这份7项问卷可推荐作为死后研究中心理解剖程序的有用工具。
