Brief alcohol screening in a clinical psychiatric population: Special attention needed


Christina Nehlin BSc, PhD Student, Anders Fredriksson MD, Associate Professor, Lennart Jansson PhD, Researcher. Ms Christina Nehlin, Department of Neuroscience, Psychiatry, Uppsala University, UAS ing 15, 3rd floor, 751 85 Uppsala, Sweden. Tel: +46 18 611 20 34; Fax: +46 18 12 20 84; E-mail:


Introduction and Aims. Abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and single-item screeners show promising results but have not previously been investigated in a clinical psychiatric setting. The aim of the present study was to investigate the capacity of three brief screening methods to detect hazardous drinking in a psychiatric treatment-seeking population.

Design and Methods. Data were collected from consecutive patients (n = 1811) visiting a general psychiatric clinic. The screening capacity of the heavy episodic drinking (HED) screener, AUDIT item # 3 (AUDIT-3) and the three consumption items of AUDIT (AUDIT-C) was compared to the result of the full 10-item AUDIT with cut-off points 6 for women and 8 for men.

Results. The HED screener and AUDIT-3 with recommended cut-offs captured low rates of hazardous drinkers when compared to the full AUDIT. Lowering the cut-offs created rates far above those of the full AUDIT. AUDIT-C with recommended cut-off limits categorised nearly the same rates of men as the full AUDIT but much higher rates of women. Raising the cut-off for women approached the detection rate of AUDIT-C closely to that of the full AUDIT.

Discussion and Conclusions. The findings of this study suggest that the HED screener is not sensitive enough in the clinical psychiatric setting. When designing alcohol screening measures to be used all over health-care organisations, special attention should be paid to psychiatric patients. If a somewhat more extensive screening tool is used, the full AUDIT is recommended.[Nehlin C, Fredriksson A, Jansson L. Brief alcohol screening in a clinical psychiatric population: Special attention needed. Drug Alcohol Rev 2012;31:538–543]