Escobar F, Espí F, Canteras M
Centro de Salud Zona IV, Albacete.
Aten Primaria. 1995 Jan;15(1):3-6.
To find the frequency of investigation of alcohol-related problems and how often alcoholic patients are identified in primary care.
A descriptive cross-sectional [correction of crossover] study.
An urban health centre.
219 patients over 15 who attended an appointment occasioned by a CAGE questionnaire validation study. 108 had answered affirmatively some of the questions in the test and 111 had answered the four questions negatively.
Diagnoses of alcoholism based on the fulfillment of the DSM-III criteria and/or on the presence of alcoholic consumption of > or = 60 grammes per day for men or 30 grammes per day for women were investigated. Additionally, each patient's medical records were checked to see whether their habitual alcohol consumption or a diagnosis of alcoholism were recorded. 54 patients were diagnosed as alcoholic. Previous inquiries into consumption of alcohol were recorded in the medical records of 167 patients (76.2%). A diagnosis of alcoholism was found to be recorded in 19 of the 54 patients who fulfilled the diagnostic criteria of our study (35.2%) and in 3 patients who did not fulfil those criteria.
Although good records of patients' habits of alcohol consumption existed, 64.8% of those diagnosed as alcoholic in our study had not been previously identified as such. This must lead us to question the efficacy of our usual diagnostic methods.
了解在初级保健中对酒精相关问题的调查频率以及识别酒精依赖患者的频率。
描述性横断面[交叉校正]研究。
一家城市健康中心。
219名15岁以上的患者,他们因一项CAGE问卷验证研究前来就诊。108名患者对测试中的一些问题回答为肯定,111名患者对四个问题回答为否定。
基于符合DSM-III标准和/或男性每日酒精摄入量≥60克或女性每日酒精摄入量≥30克来调查酒精依赖的诊断情况。此外,检查每位患者的病历,查看是否记录了他们的习惯性酒精消费情况或酒精依赖诊断。54名患者被诊断为酒精依赖。167名患者(76.2%)的病历中有既往酒精消费情况的询问记录。在符合我们研究诊断标准的54名患者中,有19名(35.2%)被发现有酒精依赖诊断记录,在不符合这些标准的3名患者中也有酒精依赖诊断记录。
尽管患者酒精消费习惯的记录良好,但在我们的研究中,64.8%被诊断为酒精依赖的患者此前未被识别出来。这必然使我们对常用诊断方法的有效性产生质疑。