Screening for hazardous alcohol use and dependence in psychiatric in-patients using the AUDIT questionnaire

The Alcohol Use Disorders Identification Test (AUDIT) has been used to scre en for hazardous and harmful alcohol consumption among general hospital pop ulations but not in psychiatric patients. Using the AUDIT, we assessed alco hol use in patients with four major types of psychiatric disorder, namely m ood, adjustment, anxiety and psychotic disorders. Nine hundred and ninety c onsecutive admissions to the psychiatric units of two hospitals during a 12 -month period underwent assessment. In each diagnostic group a high proport ion of patients was alcohol-dependent. Among those with mood disorders 25.4 % of men were alcohol-dependent, compared with 16.3% of women, while 34.5% of men with anxiety disorder were alcohol-dependent compared with 25.0% of women. Both gender differences were statistically significant. The differen ces were even greater for adjustment disorder (44.4% vs. 14.5%) and psychos is (29.2% and 4.2%, respectively). More men than women with anxiety disorde r were classified as hazardous (24.1% vs. 11.7%) or harmful drinkers (13.8% vs. 3.3%), but for the other diagnostic groupings the percentages in these drinking categories were more nearly similar. Thus, there is a high rate o f excessive alcohol consumption in people with psychiatric disorders, espec ially males. Such individuals may be particularly vulnerable to complicatio ns of alcohol misuse such as suicide and exacerbation of their disorder. Th e potential for decreased severity of psychiatric symptoms and a reduction in the number of hospital admissions following cessation or reduction in al cohol consumption is considerable. The AUDIT is a simple screening device f or investigating alcohol use and dependence, and offers a means of initiati ng intervention in this population.