Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 8, 00260, Helsinki, Finland; National Institute for Health and Welfare, Mental Health Unit, Mannerheimintie 160, 00300, Helsinki, Finland.
National Institute for Health and Welfare, Mental Health Unit, Mannerheimintie 160, 00300, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, 00260, Helsinki, Finland.
Drug Alcohol Depend. 2018 Jul 1;188:266-273. doi: 10.1016/j.drugalcdep.2018.04.015. Epub 2018 May 19.
The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents.
621 adolescents (age-range, 12-19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs.
Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was ≥5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72-83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was ≥3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46-78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%.
Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are ≥5 for AUDIT, and ≥3 for AUDIT-C.
酒精使用障碍识别测试（AUDIT）常用于成年人筛查有害饮酒，但针对青少年的使用研究较少。我们旨在验证 AUDIT 及其衍生的饮酒问卷（AUDIT-C）作为筛查工具，以检测青少年中酒精使用问题。
从临床和人群样本中抽取 621 名 12-19 岁的青少年，完成 AUDIT 问卷。使用 K-SADS-PL 评估精神科诊断。基于 K-SADS-PL 的评分用于评估饮酒习惯、酒精使用障碍、筛查和症状标准问题。计算 AUDIT 和 AUDIT-C 总分的筛查性能和受试者工作特征（ROC）曲线。计算诊断比值比（dOR）以表示截止值之间的总体差异。
AUDIT 和 AUDIT-C 对之间的 ROC 比较表明，AUDIT 在整个样本和一部分子样本中具有稍好的测试性能。对于整个样本和部分子样本，AUDIT 的最佳截断值为≥5（敏感性 0.931，特异性 0.772，dOR 45.22；95%CI：24.72-83.57），用于检测酒精使用问题。对于检测酒精使用问题，AUDIT-C 的最佳截断值为≥3（敏感性 0.952，特异性 0.663，dOR 39.31；95%CI：19.46-78.97）。使用这些截断分数，AUDIT 和 AUDIT-C 之间的一致性很高，为 91.9%。
我们确定青少年早期检测酒精使用问题的截断分数为 AUDIT≥5，AUDIT-C≥3。
