title: Under-recognized alcohol-related disorders in psychiatric outpatient unit.
abstract: OBJECTIVE
  Problematic alcohol consumption is associated with multiple medical conditions and psychiatric comorbidities. Previous publications reported the under-recognition of alcohol-related problems in the clinical setting. The present study comprises of two objectives, 1) to examine the process use by physicians to recognize alcohol-related problems in psychiatric outpatient units, and 2) to compare the results of a CAGE interview and a written version of the CAGE questionnaire.
  
  
  METHODS
  The participants were recruited via interview using the alcohol section of the Thai version of Diagnostic Interview for Genetic Studies (Th-DIGS), which included 165 psychiatric outpatients with alcohol dependence and 165 psychiatric outpatients without alcohol-related disorders. The validity of diagnoses provided by psychiatrists and physicians (in the records) compared with the Th-DIGS diagnoses were analyzed. Kappa statistics were applied to compare the agreement of the responses for the written version and the oral CAGE interviews.
  
  
  RESULTS
  Compared with the diagnoses using Th-DIGS, the physician specificity and positive predictive value were 100% (95% CI: 97.8-100% and 94.9-100%, respectively). However the sensitivity and negative predictive value were 43% (95% CI: 35.4-51%) and 63.5% (95% CI: 57.5-69.6%), respectively. The Kappa value for the written version of the CAGE questionnaire and the CAGE oral interview was 0.723.
  
  
  CONCLUSIONS
  The results of the present study suggest the need to increase physician awareness regarding alcohol-related problems. A brief and high-sensitivity screening questionnaire, such as the CAGE questionnaire, written versions and oral interview, can be implemented for screening alcohol-related disorders in a clinical setting.
authors: Woraphat
authors: W
authors: Ratta-Apha
authors: Nantawat
authors: N
authors: Sitdhiraksa
authors: Pornjira
authors: P
authors: Pariwatcharakul
authors: Nattha
authors: N
authors: Saisavoey
authors: Kanokwan
authors: K
authors: Limsricharoen
authors: Lakkhana
authors: L
authors: Thongchot
authors: Phedcharut
authors: P
authors: Kumkan
authors: Naratip
authors: N
authors: Sanguanpanich
authors: Panom
authors: P
authors: Ketumarn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013785:Thailand; D055815:Young Adult