Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis

• Published in: Adicciones (Palma de Mallorca) 2018-04, Vol.30 (4), p.251-263
• Main Authors: Sánchez Autet, Mónica, Garriga, Marina, Zamora, Francisco Javier, González, Idilio, Usall, Judith, Tolosa, Leticia, Benítez, Concepción, Puertas, Raquel, Arranz, Belén
• Format: Article
• Language: eng ; spa
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Alcoholism - diagnosis; Ambulatory Care; Cross-Sectional Studies; Diagnosis, Dual (Psychiatry); Diagnostic Self Evaluation; Female; Humans; Male; Mental Disorders - diagnosis; Middle Aged; Sex Factors; Young Adult
• ISSN: 0214-4840
• DOI: 10.20882/adicciones.885

Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.