The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons.
BACKGROUND
Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls.


METHODS
Data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1756 persons with a past-year depressive and/or anxiety disorder and 648 persons without a lifetime depressive and anxiety disorder. The performance of the AUDIT was compared against the gold standard of a CIDI-based diagnosis of past-year alcohol abuse or dependence by means of sensitivity, specificity and areas under receiver operating characteristic curves (AUCs).


RESULTS
The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC=0.89) and women (AUC==0.88), with detected cut-off points of ≥9 and ≥6, respectively, comparable to that in healthy controls (men: AUC=0.89; women: AUC=0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC=0.74) and women (AUC=0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified.


CONCLUSIONS
Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients.


CONCLUSIONS
These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.
Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, AJ Ernststraat 887, 1081 HL Amsterdam, The Netherlands. l.boschloo@vumc.nl
Lynn
L
Boschloo
Nicole
N
Vogelzangs
Johannes H
JH
Smit
Wim
W
van den Brink
Dick J
DJ
Veltman
Aartjan T F
AT
Beekman
Brenda W J H
BW
Penninx
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires