Basu Debasish, Ghosh Abhishek, Hazari Nandita, Parakh Preeti
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2016 Jun;143(6):722-730. doi: 10.4103/0971-5916.191931.
BACKGROUND & OBJECTIVES: CAGE-AID questionnaire is a short, useful screening tool for substance dependence. Assessment of one family member for the screening of substance dependence in the family could be useful in clinical practice and research. In this study, we aimed to assess the validity of the Family CAGE-AID questionnaire for the diagnosis of substance dependence.
Cross-sectional assessments using CAGE-AID and Family CAGE-AID questionnaires were conducted both for the study participants (n = 210) and their family members. The participants were recruited from two different treatment settings: a treatment seeking population from a de-addiction centre, and non-treatment seekers for substance use disorders from the psychiatry outpatient department. ICD-10 criteria and subsequent detailed clinical interview by a trained psychiatrist were used for the final diagnosis of substance dependence.
In the psychiatry outpatient group, the scores on CAGE-AID and Family CAGE-AID questionnaires were significantly correlated with the ICD-10 symptom score (r=0.81 and 0.70, respectively). In the same group, inter-rater agreement of the Family CAGE-AID was good with CAGE-AID and moderate with ICD-10 diagnosis of substance dependence (Cohen's kappa 0.78 and 0.61, respectively). A cut-off score of three on Family CAGE-AID was found to be 95·8 per cent sensitive and 100 per cent specific.
INTERPRETATION & CONCLUSIONS: Family CAGE-AID questionnaire is a valid screening instrument for the diagnosis of substance dependence, with acceptable sensitivity and specificity of a cut-off score of three. The simplicity and the brevity of such an instrument can be valuable in the clinical settings of developing countries and also for epidemiological studies.
CAGE-AID问卷是一种简短且实用的物质依赖筛查工具。评估一名家庭成员以筛查家庭中的物质依赖情况在临床实践和研究中可能会有所帮助。在本研究中,我们旨在评估家庭CAGE-AID问卷对物质依赖诊断的有效性。
使用CAGE-AID问卷和家庭CAGE-AID问卷对研究参与者(n = 210)及其家庭成员进行横断面评估。参与者从两个不同的治疗机构招募:一个是来自戒毒中心寻求治疗的人群,另一个是来自精神科门诊的物质使用障碍非寻求治疗者。国际疾病分类第十版(ICD-10)标准以及随后由经过培训的精神科医生进行的详细临床访谈用于物质依赖的最终诊断。
在精神科门诊组中,CAGE-AID问卷和家庭CAGE-AID问卷的得分与ICD-10症状评分显著相关(分别为r = 0.81和0.70)。在同一组中,家庭CAGE-AID与CAGE-AID之间的评分者间一致性良好,与ICD-10物质依赖诊断的一致性中等(科恩kappa系数分别为0.78和0.61)。发现家庭CAGE-AID问卷的截断分数为3时,敏感性为95.8%,特异性为100%。
家庭CAGE-AID问卷是一种有效的物质依赖诊断筛查工具,截断分数为3时具有可接受的敏感性和特异性。这种工具的简单性和简短性在发展中国家的临床环境以及流行病学研究中可能具有重要价值。