PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of pubhealthrepPublic Health Reports
 
Public Health Rep. 1988 Nov-Dec; 103(6): 586–592.
PMCID: PMC1478147

Screening for alcoholism: techniques and issues.

Abstract

Alcoholism is an often overlooked health problem because alcoholics usually do not seek treatment for their drinking problems. They do, however, seek general medical care for other health reasons, and a number of screening techniques have proven useful for identifying alcoholics. The advantages and disadvantages of self-report, as well as biochemical techniques that have been found effective in screening for alcoholism, are discussed. We recommend that future research be aimed at developing quick, accurate, and inexpensive screening devices that also can evaluate the severity of the alcohol problem. Ideally, screening procedures would discourage feigned responses, differentiate between drinking and consequences of drinking, and permit the identification of subtypes of alcoholics. Better understanding of the types of errors made by common screening instruments would enable researchers to construct an optimal sequencing strategy for screening for alcoholism.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Shapiro S, Skinner EA, Kessler LG, Von Korff M, German PS, Tischler GL, Leaf PJ, Benham L, Cottler L, Regier DA. Utilization of health and mental health services. Three Epidemiologic Catchment Area sites. Arch Gen Psychiatry. 1984 Oct;41(10):971–978. [PubMed]
  • Selzer ML. The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971 Jun;127(12):1653–1658. [PubMed]
  • Swenson WM, Morse RM. The use of a self-administered alcoholism screening test (SAAST) in a medical center. Mayo Clin Proc. 1975 Apr;50(4):204–208. [PubMed]
  • McLellan AT, Luborsky L, Woody GE, O'Brien CP, Druley KA. Predicting response to alcohol and drug abuse treatments. Role of psychiatric severity. Arch Gen Psychiatry. 1983 Jun;40(6):620–625. [PubMed]
  • MACANDREW C. THE DIFFERENTIATION OF MALE ALCOHOLIC OUTPATIENTS FROM NONALCOHOLIC PSYCHIATRIC OUTPATIENTS BY MEANS OF THE MMPI. Q J Stud Alcohol. 1965 Jun;26:238–246. [PubMed]
  • Preng KW, Clopton JR. The MacAndrew Scale: clinical application and theoretical issues. J Stud Alcohol. 1986 May;47(3):228–236. [PubMed]
  • Bagrel A, d'Houtaud A, Gueguen R, Siest G. Relations between reported alcohol consumption and certain biological variables in an "unselected" population. Clin Chem. 1979 Jul;25(7):1242–1246. [PubMed]
  • Papoz L, Warnet JM, Péquignot G, Eschwege E, Claude JR, Schwartz D. Alcohol consumption in a healthy population. Relationship to gamma-glutamyl transferase activity and mean corpuscular volume. JAMA. 1981 May 1;245(17):1748–1751. [PubMed]
  • Whitehead TP, Clarke CA, Whitfield AG. Biochemical and haematological markers of alcohol intake. Lancet. 1978 May 6;1(8071):978–981. [PubMed]
  • Whitfield JB, Hensley WJ, Bryden D, Gallagher H. Some laboratory correlates of drinking habits. Ann Clin Biochem. 1978 Nov;15(6):297–303. [PubMed]
  • Wu A, Chanarin I, Levi AJ. Macrocytosis of chronic alcoholism. Lancet. 1974 May 4;1(7862):829–831. [PubMed]
  • Unger KW, Johnson D., Jr Red blood cell mean corpuscular volume: a potential indicator of alcohol usage in a working population. Am J Med Sci. 1974 May;267(5):281–289. [PubMed]
  • Rosalki SB, Rau D. Serum -glutamyl transpeptidase activity in alcoholism. Clin Chim Acta. 1972 Jun;39(1):41–47. [PubMed]
  • Wu A, Slavin G, Levi AJ. Elevated serum gamma-glutamyl-transferase (transpeptidase) and histological liver damage in alcoholism. Am J Gastroenterol. 1976 Apr;65(4):318–323. [PubMed]
  • Eckardt MJ, Ryback RS, Rawlings RR, Graubard BI. Biochemical diagnosis of alcoholism. A test of the discriminating capabilities of gamma-glutamyl transpeptidase and mean corpuscular volume. JAMA. 1981 Dec 11;246(23):2707–2710. [PubMed]
  • Ryback RS, Eckardt MJ, Felsher B, Rawlings RR. Biochemical and hematologic correlates of alcoholism and liver disease. JAMA. 1982 Nov 12;248(18):2261–2265. [PubMed]
  • Stamm D, Hansert E, Feuerlein W. Detection and exclusion of alcoholism in men on the basis of clinical laboratory findings. J Clin Chem Clin Biochem. 1984 Jan;22(1):79–96. [PubMed]
  • Ryback RS, Eckardt MJ, Rawlings RR, Rosenthal LS. Quadratic discriminant analysis as an aid to interpretive reporting of clinical laboratory tests. JAMA. 1982 Nov 12;248(18):2342–2345. [PubMed]
  • Rawlings RR, Rae DS, Graubard BI, Eckardt MJ, Ryback RS. A methodology for construction of a multivariate diagnostic instrument: an application to alcohol abuse screening. Comput Biomed Res. 1982 Jun;15(3):228–239. [PubMed]
  • Ryback RS, Eckardt MJ, Pautler CP. Biochemical and hematological correlates of alcoholism. Res Commun Chem Pathol Pharmacol. 1980 Mar;27(3):533–550. [PubMed]
  • Rutstein DD, Veech RL, Nickerson RJ, Felver ME, Vernon AA, Needham LL, Kishore P, Thacker SB. 2,3-butanediol: an unusual metabolite in the serum of severely alcoholic men during acute intoxication. Lancet. 1983 Sep 3;2(8349):534–537. [PubMed]
  • Shaw S, Stimmel B, Lieber CS. Plasma alpha amino-n-butyric acid to leucine ratio: an empirical biochemical marker of alcoholism. Science. 1976 Dec 3;194(4269):1057–1058. [PubMed]
  • Tabakoff B, Hoffman PL, Lee JM, Saito T, Willard B, De Leon-Jones F. Differences in platelet enzyme activity between alcoholics and nonalcoholics. N Engl J Med. 1988 Jan 21;318(3):134–139. [PubMed]
  • Stibler H, Borg S, Joustra M. Micro anion exchange chromatography of carbohydrate-deficient transferrin in serum in relation to alcohol consumption (Swedish Patent 8400587-5). Alcohol Clin Exp Res. 1986 Oct;10(5):535–544. [PubMed]
  • Stibler H, Hultcrantz R. Carbohydrate-deficient transferrin in serum in patients with liver diseases. Alcohol Clin Exp Res. 1987 Oct;11(5):468–473. [PubMed]
  • Behrens UJ, Worner TM, Braly LF, Schaffner F, Lieber CS. Carbohydrate-deficient transferrin, a marker for chronic alcohol consumption in different ethnic populations. Alcohol Clin Exp Res. 1988 Jun;12(3):427–432. [PubMed]
  • Hoerner M, Behrens UJ, Worner T, Lieber CS. Humoral immune response to acetaldehyde adducts in alcoholic patients. Res Commun Chem Pathol Pharmacol. 1986 Oct;54(1):3–12. [PubMed]
  • San George RC, Hoberman HD. Reaction of acetaldehyde with hemoglobin. J Biol Chem. 1986 May 25;261(15):6811–6821. [PubMed]
  • Niemelä O, Klajner F, Orrego H, Vidins E, Blendis L, Israel Y. Antibodies against acetaldehyde-modified protein epitopes in human alcoholics. Hepatology. 1987 Nov-Dec;7(6):1210–1214. [PubMed]
  • Lin RC, Smith RS, Lumeng L. Detection of a protein-acetaldehyde adduct in the liver of rats fed alcohol chronically. J Clin Invest. 1988 Feb;81(2):615–619. [PMC free article] [PubMed]
  • Kristenson H, Trell E, Hood B. Serum-gamma-glutamyltransferase in screening and continuous control of heavy drinking in middle-aged men. Am J Epidemiol. 1981 Dec;114(6):862–872. [PubMed]
  • Babor TF, Ritson EB, Hodgson RJ. Alcohol-related problems in the primary health care setting: a review of early intervention strategies. Br J Addict. 1986 Feb;81(1):23–46. [PubMed]
  • Skinner HA, Holt S, Sheu WJ, Israel Y. Clinical versus laboratory detection of alcohol abuse: the alcohol clinical index. Br Med J (Clin Res Ed) 1986 Jun 28;292(6537):1703–1708. [PMC free article] [PubMed]

Articles from Public Health Reports are provided here courtesy of SAGE Publications