University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany; German Center for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany.
University of Luebeck, Department of Psychiatry and Psychotherapy, Ratzeburger Allee 160, D-23538 Luebeck, Germany.
Drug Alcohol Depend. 2019 Nov 1;204:107530. doi: 10.1016/j.drugalcdep.2019.06.032. Epub 2019 Aug 30.
The Alcohol Use Disorders Identification Test (AUDIT) is an established screening questionnaire for the detection of at-risk drinking and possible alcohol use disorders (AUD) according to the Diagnostic and Statistical Manual of Mental Disorders - fourth edition (DSM-IV). But there are still no comparable results on the diagnostic performance regarding the new criteria for AUD in the Diagnostic and Statistical Manual of Mental Disorders - fifth edition (DSM-5), especially taking account of possible gender differences. We evaluated the performance of the full AUDIT and the consumption questions (AUDIT-C) in screening for DSM-5 AUD and at-risk drinking.
Data from the study Transitions in Alcohol Consumption and Smoking (TACOS) is used to analyze the area under the receiver-operating characteristic curve, sensitivity, and specificity of the AUDIT and the AUDIT-C in the general population of northern Germany. DSM-5 AUD and at-risk drinking were assessed with the Munich-Composite Diagnostic Interview and used as gold standards.
The best balance between sensitivity and specificity is achieved at a score of 5 for men and 4 for women. High severity, according to DSM-5, were associated with higher cut-offs.
Both AUDIT versions are accurate in the screening for DSM-5 AUD. Since the proposed cut-offs do not differ from the optimal screening cut-offs for DSM-IV disorders, current screening procedures should not face major changes.
酒精使用障碍识别测试(AUDIT)是一种已确立的筛查问卷,用于根据《精神障碍诊断与统计手册-第四版》(DSM-IV)检测高危饮酒和可能的酒精使用障碍(AUD)。但是,关于《精神障碍诊断与统计手册-第五版》(DSM-5)中 AUD 的新标准,仍然没有可比的诊断性能结果,尤其是考虑到可能存在的性别差异。我们评估了完整的 AUDIT 和消费问题(AUDIT-C)在筛查 DSM-5 AUD 和高危饮酒方面的表现。
使用来自酒精消费和吸烟过渡期研究(TACOS)的数据,分析德国北部普通人群中 AUDIT 和 AUDIT-C 的受试者工作特征曲线下面积、敏感性和特异性。使用慕尼黑综合诊断访谈评估 DSM-5 AUD 和高危饮酒,并将其作为金标准。
对于男性,最佳的敏感性和特异性平衡在得分为 5 分,对于女性,最佳的敏感性和特异性平衡在得分为 4 分。根据 DSM-5,严重程度高与较高的截断值相关。
这两种 AUDIT 版本在筛查 DSM-5 AUD 方面都很准确。由于提出的截断值与 DSM-IV 障碍的最佳筛查截断值没有差异,因此当前的筛查程序不应面临重大变化。