title: How CAGE, RAPS4-QF, and AUDIT Can Help Practitioners for Patients Admitted with Acute Alcohol Intoxication in Emergency Departments?
abstract: OBJECTIVE
  To help clinicians to identify the severity of alcohol use disorders (AUDs) from optimal thresholds found for recommended scales. Especially, taking account of the high prevalence of alcohol dependence among patients admitted to the emergency department (ED) for acute alcohol intoxication (AAI), we propose to define thresholds of severity of dependence based on the AUDIT score.
  
  
  METHODS
  All patients admitted to the ED with AAI (blood alcohol level >0.8 g/L), in a 2-month period, were assessed using the CAGE, RAPS-QF, and AUDIT, with the alcohol dependence/abuse section of the mini international neuropsychiatric interview (MINI) used as the gold standard. To explore the relation between the AUDIT and the MINI the sum of the positive items on the MINI (dependence) as a quantitative variable and as an ordinal parameter were analyzed. From the threshold score found for each scale we proposed intervals of severity of AUDs.
  
  
  RESULTS
  The mean age of the sample (122 males, 42 females) was 46 years. Approximately 12% of the patients were identified with alcohol abuse and 78% with dependence (DSM-IV). Cut points were determined for the AUDIT in order to distinguish mild and moderate dependence from severe dependence. A strategy of intervention based on levels of severity of AUD was proposed.
  
  
  CONCLUSIONS
  Different thresholds proposed for the CAGE, RAPS4-QF, and AUDIT could be used to guide the choice of intervention for a patient: brief intervention, brief negotiation interviewing, or longer more intensive motivational intervention.
authors.affiliation: Service Psychiatrie et Addictologie de l'Adulte CMP B, CHU Clermont Ferrand , Clermont Ferrand , France ; EA 7280 UFR Médecine, Université Clermont 1 , Clermont Ferrand , France.
authors.forename: Georges
authors.initials: G
authors.lastname: Brousse
authors.affiliation: Service Psychiatrie et Addictologie de l'Adulte CMP B, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Arnaud
authors.affiliation: Service Accueil Urgences, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Julie
authors.initials: J
authors.lastname: Geneste
authors.affiliation: Delegation Recherche Clinique et Innovation, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Service Psychiatrie et Addictologie de l'Adulte CMP B, CHU Clermont Ferrand , Clermont Ferrand , France ; EA 7280 UFR Médecine, Université Clermont 1 , Clermont Ferrand , France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: De Chazeron
authors.affiliation: Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), Université Blaise Pascal , Clermont Ferrand , France.
authors.forename: Frederique
authors.initials: F
authors.lastname: Teissedre
authors.affiliation: Service Accueil Urgences, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Perrier
authors.affiliation: Service de Psychiatrie, CHU Nancy , Toul , France.
authors.forename: Raymund
authors.initials: R
authors.lastname: Schwan
authors.affiliation: Service Psychiatrie et Addictologie de l'Adulte CMP B, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Malet
authors.affiliation: Service Accueil Urgences, CHU Clermont Ferrand , Clermont Ferrand , France.
authors.forename: Jeannot
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: Service Psychiatrie et Addictologie de l'Adulte CMP B, CHU Clermont Ferrand , Clermont Ferrand , France ; EA 7280 UFR Médecine, Université Clermont 1 , Clermont Ferrand , France.
authors.forename: Pierre Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: Alcohol Research Group , Emeryville, CA , USA.
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Cherpitel
keywords: AUDIT; CAGE; RAPS4-QF; brief interventions; drunkenness; emergency department