Smith Jessica J, Spanakis Panagiotis, Gribble Rachael, Stevelink Sharon A M, Rona Roberto J, Fear Nicola T, Goodwin Laura
Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom.
Department of Health Sciences, University of York, York, United Kingdom.
Drug Alcohol Depend. 2022 Jun 1;235:109449. doi: 10.1016/j.drugalcdep.2022.109449. Epub 2022 Apr 9.
There is a prominent "treatment gap" in relation to at-risk drinking (ARD), whereby a minority of at-risk drinkers ever access treatment. Research suggests that recognition of problem drinking is a necessary precursor for help-seeking and treatment.
This systematic review and meta-analysis aimed to estimate the prevalence of ARD recognition within those meeting criteria for ARD.
PsycINFO, Web of Science, Scopus, and MEDLINE were searched using the terms: problem* AND (recogni* OR perceive* OR perception OR self-identif*) AND alcohol - to identify studies published in English between 2000 and 2022. Studies reported the frequency (weighted or unweighted) of participants meeting ARD criteria that also directly identified ARD, perceived a need for help, or endorsed a readiness to change. The prevalence of ARD recognition was estimated using a random-effects meta-analysis with 95% confidence intervals (CIs).
17 studies were included which provided data for 33,349 participants with ARD. Most (n = 14) were US studies. ARD was self-identified via a single indicator in 7 studies, whereas recognition was assessed via stages of change in 4 studies and need for help in 6 studies. The pooled prevalence of ARD recognition was 31% (95% CI: 25%-36%), and subgroup analyses indicated alcohol use severity, measure of recognition, and population type to be significant sources of heterogeneity.
Most individuals with ARD fail to recognise their drinking problem so preventive approaches that promote recognition may be helpful. However, we must be cautious of how inconsistency in question framing affects self-reported problem recognition.
在危险饮酒（ARD）方面存在显著的“治疗差距”，即只有少数危险饮酒者接受过治疗。研究表明，认识到饮酒问题是寻求帮助和治疗的必要前提。
本系统评价和荟萃分析旨在估计符合ARD标准的人群中认识到ARD的患病率。
使用以下检索词在PsycINFO、科学网、Scopus和MEDLINE数据库中进行检索：problem* AND (recogni* OR perceive* OR perception OR self-identif*) AND alcohol，以识别2000年至2022年期间发表的英文研究。这些研究报告了符合ARD标准且直接识别出ARD、意识到需要帮助或表示愿意改变的参与者的频率（加权或未加权）。使用随机效应荟萃分析估计ARD认识的患病率，并给出95%置信区间（CI）。
纳入了17项研究，这些研究为33349名患有ARD的参与者提供了数据。大多数研究（n = 14）来自美国。7项研究通过单一指标自我识别ARD，而4项研究通过改变阶段评估认识情况，6项研究通过对帮助的需求评估认识情况。ARD认识的合并患病率为31%（�5% CI：25% - 36%），亚组分析表明饮酒严重程度、认识测量方法和人群类型是异质性的重要来源。
大多数患有ARD的个体未认识到自己的饮酒问题，因此促进认识的预防方法可能会有所帮助。然而，我们必须谨慎对待问题框架的不一致如何影响自我报告的问题认识。
