title: Different methods of early identification of risky drinking: a review of clinical signs.
abstract: OBJECTIVE
  To review the literature on detection of risky drinking to compare early identification based on everyday clinical encounters with systematic screening. We also reviewed specific clinical signs that have been suggested to be used as indicators of risky drinking.
  
  
  METHODS
  A literature review was performed in PubMed and CINAHL of articles up to November 2010.
  
  
  RESULTS
  Systematic screening and semi-systematic methods in various forms detected more risky drinkers than non-systematic identification during clinical encounter, but there was a lack of studies comparing the various means of identifying risky drinking. It may be too early to completely rule out the possibility of using non-systematic methods as an effective strategy to identify risky drinking. The earliest signs of risky drinking suggested in the literature are psychological distress and social problems.
  
  
  CONCLUSIONS
  From a public health perspective, there is a lack of evidence that non-systematic or semi-systematic methods can substitute systematic screening in terms of numbers of risky drinkers detected. If early signs are going to be used to identify risky drinkers, or those to be screened for risky drinking, more focus should be on psychological and social signs because they appear earlier than somatic signs.
authors.affiliation: Department of Social Medicine, the Sahlgrenska Academy, University of Gothenburg, PO Box 453, 40530 Göteborg, Sweden. hanna.reinholdz@gu.se
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Reinholdz
authors.forename: Preben
authors.initials: P
authors.lastname: Bendtsen
authors.forename: Fredrik
authors.initials: F
authors.lastname: Spak
mesh_terms: D000428:Alcohol Drinking / Q000523:psychology*; D000435:Alcoholic Intoxication / Q000175:diagnosis* / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology; D002492:Central Nervous System Depressants / Q000009:adverse effects; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012309:Risk-Taking; D015813:Substance Abuse Detection / Q000379:methods*; D013997:Time Factors
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol