Clinical utility of a single-item test for DSM-5 alcohol use disorder among outpatients with anxiety and depressive disorders.
There is a lack of studies testing accuracy of fast screening methods for alcohol use disorder in mental health settings. We aimed at estimating clinical utility of a standard single-item test for case finding and screening of DSM-5 alcohol use disorder among individuals suffering from anxiety and mood disorders.



We recruited adults consecutively referred, in a 12-month period, to an outpatient clinic for anxiety and depressive disorders. We assessed the National Institute on Alcohol Abuse and Alcoholism (NIAAA) single-item test, using the Mini- International Neuropsychiatric Interview (MINI), plus an additional item of Composite International Diagnostic Interview (CIDI) for craving, as reference standard to diagnose a current DSM-5 alcohol use disorder. We estimated sensitivity and specificity of the single-item test, as well as positive and negative Clinical Utility Indexes (CUIs).



242 subjects with anxiety and mood disorders were included. The NIAAA single-item test showed high sensitivity (91.9%) and specificity (91.2%) for DSM-5 alcohol use disorder. The positive CUI was 0.601, whereas the negative one was 0.898, with excellent values also accounting for main individual characteristics (age, gender, diagnosis, psychological distress levels, smoking status).



Testing for relevant indexes, we found an excellent clinical utility of the NIAAA single-item test for screening true negative cases. Our findings support a routine use of reliable methods for rapid screening in similar mental health settings.
Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy. Electronic address: f.bartoli@campus.unimib.it.
Francesco
F
Bartoli
Department of Mental Health, San Gerardo Hospital, Monza, Italy.
Cristina
C
Crocamo
Department of Mental Health, San Gerardo Hospital, Monza, Italy.
Enrico
E
Biagi
Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy.
Francesco
F
Di Carlo
Department of Psychology, University of Milano Bicocca, Milano, Italy.
Francesca
F
Parma
Department of Psychology, University of Milano Bicocca, Milano, Italy.
Fabio
F
Madeddu
Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy; Department of Mental Health, San Gerardo Hospital, Monza, Italy.
Enrico
E
Capuzzi
Department of Mental Health, San Gerardo Hospital, Monza, Italy.
Fabrizia
F
Colmegna
Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy; Department of Mental Health, San Gerardo Hospital, Monza, Italy.
Massimo
M
Clerici
Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy; Department of Mental Health, San Gerardo Hospital, Monza, Italy; Division of Psychiatry, University College London, London, UK.
Giuseppe
G
Carrà
D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010045:Outpatients / Q000523:psychology
Alcohol use disorder; Anxiety; Comorbidity; DSM-5; Depression; Dual diagnosis; Screening