Clark Duncan B, Chung Tammy, Martin Christopher
Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Int J Adolesc Med Health. 2006 Jan-Mar;18(1):181-7. doi: 10.1515/ijamh.2006.18.1.181.
While screening tools have been developed to identify adolescents likely to have alcohol use disorders (AUDs), none of the available methods are optimal for general medical settings. This study explored the sensitivity and specificity of the frequency of drinking episodes in the prior month as an initial screen for AUDs. The subjects were 219 adolescents (ages 12 through 18) systematically recruited from the community, who participated in a baseline assessment as well as 1-year, 3-year, and 5-year follow-up visits. Subjects completed a self-report form indicating their frequency of use of different substances in the month prior to the assessment. DSM-IV AUD diagnoses were determined by SCID. At baseline, 10 of 219 subjects met DSM-IV criteria for an AUD. At a threshold of 3 or more drinking episodes in the past month, the screen was 90% sensitive, correctly classifying 9 of 10 AUD cases, and 83.7% specific, correctly classifying 175 of 209 cases without AUDs. The diminishing specificity of this screen over the follow-up assessments indicated that this method may be useful for adolescents, but not for young adults. These results indicate that an assessment of the frequency of alcohol use in the prior month provides an initial screen with acceptable sensitivity and specificity for use with adolescents.
虽然已经开发出筛查工具来识别可能患有酒精使用障碍（AUDs）的青少年，但现有的方法在普通医疗环境中都不是最优的。本研究探讨了前一个月饮酒次数作为AUDs初步筛查的敏感性和特异性。研究对象是从社区系统招募的219名青少年（年龄在12岁至18岁之间），他们参加了基线评估以及1年、3年和5年的随访。受试者填写了一份自我报告表格，表明他们在评估前一个月使用不同物质的频率。DSM-IV AUD诊断由SCID确定。在基线时，219名受试者中有10名符合DSM-IV的AUD标准。以过去一个月内饮酒3次或更多次为阈值，该筛查的敏感性为90%，正确分类了10例AUD病例中的9例，特异性为83.7%，正确分类了209例无AUD病例中的175例。在后续评估中，该筛查的特异性逐渐降低，这表明该方法可能对青少年有用，但对年轻人无用。这些结果表明，对前一个月饮酒频率的评估为青少年提供了一个具有可接受敏感性和特异性的初步筛查。
