Clinical utility of a single-item test for DSM-5 alcohol use disorder among outpatients with anxiety and depressive disorders. (1st August 2016)

• Record Type: Journal Article
• Authors: Bartoli, Francesco; Crocamo, Cristina; Biagi, Enrico; Di Carlo, Francesco; Parma, Francesca; Madeddu, Fabio; Capuzzi, Enrico; Colmegna, Fabrizia; Clerici, Massimo; Carrà, Giuseppe
• Is Part Of: Drug and alcohol dependence. Volume 165(2016)
• Page Start: 283
• Page End: 287
• Publication Date: 2016-08-01
• Subjects: Alcohol use disorder -- DSM-5 -- Anxiety -- Depression -- Screening -- Comorbidity -- Dual diagnosis; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2016.06.003
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: We tested clinical utility of a single-item test for DSM-5 alcohol use disorder. We selected a sample of people with anxiety and depressive disorders. The single-item test showed an excellent negative clinical utility index. A routine use of fast screening methods in mental health settings is recommended. Abstract: Background: 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. Methods: 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). Results: 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). Discussion: 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.