Publication: Under-recognized alcohol-related disorders in psychiatric outpatient unit
Issued Date
2014-01-01
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ISSN
01252208
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2-s2.0-84902259255
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.97, No.4 (2014), 439-446
Suggested Citation
Woraphat Ratta-Apha, Nantawat Sitdhiraksa, Pornjira Pariwatcharakul, Nattha Saisavoey, Kanokwan Limsricharoen, Lakkhana Thongchot, Phedcharut Kumkan, Naratip Sanguanpanich, Panom Ketumarn Under-recognized alcohol-related disorders in psychiatric outpatient unit. Journal of the Medical Association of Thailand. Vol.97, No.4 (2014), 439-446. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34534
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Title
Under-recognized alcohol-related disorders in psychiatric outpatient unit
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Abstract
Objective: Problematic alcohol consumption is associated with multiple medical conditions and psychiatric comorbidities. Previous publications reported the under-recognition of alcohol-related problems in the clinical setting. The present study comprises of two objectives, 1) to examine the process use by physicians to recognize alcohol-related problems in psychiatric outpatient units, and 2) to compare the results of a CAGE interview and a written version of the CAGE questionnaire. Material and Method: The participants were recruited via interview using the alcohol section of the Thai version of Diagnostic Interview for Genetic Studies (Th-DIGS), which included 165 psychiatric outpatients with alcohol dependence and 165 psychiatric outpatients without alcohol-related disorders. The validity of diagnoses provided by psychiatrists and physicians (in the records) compared with the Th-DIGS diagnoses were analyzed. Kappa statistics were applied to compare the agreement of the responses for the written version and the oral CAGE interviews. Results: Compared with the diagnoses using Th-DIGS, the physician specificity and positive predictive value were 100% (95% CI: 97.8-100% and 94.9-100%, respectively). However, the sensitivity and negative predictive value were 43% (95% CI: 35.4-51%) and 63.5% (95% CI: 57.5-69.6%), respectively. The Kappa value for the written version of the CAGE questionnaire and the CAGE oral interview was 0.723. Conclusion: The results of the present study suggest the need to increase physician awareness regarding alcohol-related problems. A brief and high-sensitivity screening questionnaire, such as the CAGE questionnaire, written versions and oral interview, can be implemented for screening alcohol-related disorders in a clinical setting.