In The Netherlands general practice attenders are not usually question
ed about their drinking habits. The objective of this study was to det
ermine to what extent easily available data (e.g. age, gender) can be
used to identify categories of patients who are at risk of problem dri
nking as a preliminary to more intensive screening. Sixteen practices
with a total population of 32,000 patients were involved in the study.
All problem drinkers known by their GPs and a random sample of one in
ten patients not thought to be problem drinkers were admitted to the
study at their first surgery visit during a 1-year period. A screening
questionnaire was used to find hidden problem drinkers amongst the in
dividuals thought to be non-problem drinkers. The overall response rat
e was 91% (n = 1405). Problem drinking was detected in 6% (n = 82) of
the group regarded by the GPs as non-problem drinkers (n = 1283). Male
gender, smoking, life events and chronic social problems were the str
ongest nonalcohol-related predictors of hidden problem drinking. We co
nclude that a pre-selection of patients with a greater risk of problem
drinking can be made without information related directly to alcohol.
Case-finding in this category is much more effective and probably muc
h more acceptable both to the GP and the patients, than the screening
of all patients.