Backgrounds : Based on the DSM-IV criteria, drinking problems were diagnosed as abuse or dependence under the alcohol use disorders. The present study tried to compare the sensitivities and specificities of alcoholism screening tools for the diagnostic criteria.
Methods : The 96 drinking male subjects were classified into ´normal´, ´abuse´ and ´dependence´ through the structured interviews based on DSM-IV criteria. Independently of the diagnostic interviews, they were asked to answer the four screening questionnaires frequently used in family practice such as CAGE, MAST, NAST, and AUDIT.
Results : On performance of diagnostic interviews with 96 subjects, normal subjects were 50
(52.1%), subjects with alcohol abuse 37 (38.5%), and subjects with alcohol dependence 9 (9.4%). The standard cut-off values of the questionnaires for screening alcohol use disorders were above 15 points in AUDIT, above 5 points in MAST, above one item in NAST, and above 2 items in CAGE. The questionnaire of NAST showed the highest sensitivity of 93.5% while CAGE showed the highest specificity of 90.0% for alcohol use disorders. For screening alcohol dependence, above 26 points were required in AUDIT, above 13 points in MAST, above 5 items in NAST, and above 3 items in CAGE. The questionnaire of AUDIT showed the highest sensitivity of 100.0% while both AUDIT and NAST showed the highest specificity of 94.3% for alcohol dependence.
Conclusion : For the purpose of screening alcohol use disorders in a broader spectrum, AUDIT and NAST were shown to be better than the others. The AUDIT was also the best tool to screen alcohol dependence.
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