Breakey W R, Calabrese L, Rosenblatt A, Crum R M
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Community Ment Health J. 1998 Apr;34(2):165-74. doi: 10.1023/a:1018793002740.
The frequent co-occurrence of alcoholism with serious mental illnesses ("dual diagnosis") necessitates that clinicians are able to recognize its presence in people with disabling mental illnesses. This study demonstrates that professionals often miss the diagnosis, but that their ability to detect alcoholism can be greatly enhanced by the use of a simple screening tool. Members of an urban psychosocial rehabilitation program who received psychiatric treatment in an affiliated outpatient clinic were interviewed after their clinic therapists and rehabilitation counselors had been asked questions pertaining to their general health and substance use. The members were interviewed with two screening tests, the CAGE and the SMAST, and a clinical DSM-III-R diagnosis of alcohol use disorder was established. Both the SMAST and CAGE had good sensitivity and the addition of a screener enhanced the clinicians' ability to detect alcohol use disorders.
酒精成瘾与严重精神疾病常同时出现（“双重诊断”），这就要求临床医生能够识别出患有致残性精神疾病的患者中存在酒精成瘾情况。本研究表明，专业人员常常漏诊，但使用一种简单的筛查工具可大大提高他们检测酒精成瘾的能力。在一家附属门诊接受精神科治疗的城市心理社会康复项目成员，在其门诊治疗师和康复顾问被问及有关他们的总体健康状况和物质使用情况的问题之后接受了访谈。对这些成员进行了两项筛查测试，即CAGE测试和SMAST测试，并依据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）对酒精使用障碍进行了临床诊断。SMAST测试和CAGE测试都具有良好的敏感性，增加一种筛查工具可提高临床医生检测酒精使用障碍的能力。
