Alcohol and Alcoholism Vol. 37, No. 3, pp. 261-268, 2002
© 2002 Medical Council on Alcohol
SCREENING FOR ALCOHOL USE DISORDERS AND AT-RISK DRINKING IN THE GENERAL POPULATION: PSYCHOMETRIC PERFORMANCE OF THREE QUESTIONNAIRES
Medical University of Lübeck, Department of Psychiatry and Psychotherapy, Research Group S:TEP (Substance Abuse: Treatment, Epidemiology, and Prevention), Lübeck and
1 University of Greifswald, Institute of Epidemiology and Social Medicine, Addiction Research Center, Greifswald, Germany
Received 29 December 2000; first review notified 7 September 2001; accepted 18 November 2001
— Most screening questionnaires are developed in clinical settings and there are few data on their performance in the general population. This study provides data on the area under the receiver-operating characteristic (ROC) curve, sensitivity, specificity, and internal consistency of the Alcohol Use Disorders Identification Test (AUDIT), the consumption questions of the AUDIT (AUDIT-C) and the Lübeck Alcohol Dependence and Abuse Screening Test (LAST) among current drinkers (n = 3551) of a general population sample in northern Germany. Alcohol dependence and misuse according to DSM-IV and at-risk drinking served as gold standards to assess sensitivity and specificity and were assessed with the Munich–Composite Diagnostic Interview (M-CIDI). AUDIT and LAST showed insufficient sensitivity for at-risk drinking and alcohol misuse using standard cut-off scores, but satisfactory detection rates for alcohol dependence. The AUDIT-C showed low specificity in all criterion groups with standard cut-off. Adjusted cut-points are recommended. Among a subsample of individuals with previous general hospital admission in the last year, all questionnaires showed higher internal consistency suggesting lower reliability in non-clinical samples. In logistic regression analyses, having had a hospital admission increased the sensitivity in detecting any criterion group of the LAST, and the number of recent general practice visits increased the sensitivity of the AUDIT in detecting alcohol misuse. Women showed lower scores and larger areas under the ROC curves. It is concluded that setting specific instruments (e.g. primary care or general population) or adjusted cut-offs should be used.
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