The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons

Lynn Boschloo, Nicole Vogelzangs, Johannes H Smit, Wim van den Brink, Dick J Veltman, Aartjan T F Beekman, Brenda W J H Penninx

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls.

METHODS: Data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1756 persons with a past-year depressive and/or anxiety disorder and 648 persons without a lifetime depressive and anxiety disorder. The performance of the AUDIT was compared against the gold standard of a CIDI-based diagnosis of past-year alcohol abuse or dependence by means of sensitivity, specificity and areas under receiver operating characteristic curves (AUCs).

RESULTS: The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC=0.89) and women (AUC==0.88), with detected cut-off points of ≥9 and ≥6, respectively, comparable to that in healthy controls (men: AUC=0.89; women: AUC=0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC=0.74) and women (AUC=0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified.

LIMITATIONS: Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients.

CONCLUSIONS: These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalJournal of Affective Disorders
Volume126
Issue number3
Early online date4 Jun 2010
DOIs
Publication statusPublished - Nov 2010

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Alcoholism
Alcohols
Area Under Curve
Population
Depressive Disorder
Anxiety Disorders
Sensitivity and Specificity
ROC Curve
Netherlands
Anxiety
Depression

Keywords

  • Adult
  • Alcoholism/diagnosis
  • Anxiety Disorders/diagnosis
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder/diagnosis
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Humans
  • Male
  • Mass Screening/statistics & numerical data
  • Middle Aged
  • Psychometrics/statistics & numerical data
  • Reproducibility of Results
  • Surveys and Questionnaires

Cite this

Boschloo, Lynn ; Vogelzangs, Nicole ; Smit, Johannes H ; van den Brink, Wim ; Veltman, Dick J ; Beekman, Aartjan T F ; Penninx, Brenda W J H. / The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons. In: Journal of Affective Disorders. 2010 ; Vol. 126, No. 3. pp. 441-446.
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abstract = "BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls.METHODS: Data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1756 persons with a past-year depressive and/or anxiety disorder and 648 persons without a lifetime depressive and anxiety disorder. The performance of the AUDIT was compared against the gold standard of a CIDI-based diagnosis of past-year alcohol abuse or dependence by means of sensitivity, specificity and areas under receiver operating characteristic curves (AUCs).RESULTS: The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC=0.89) and women (AUC==0.88), with detected cut-off points of ≥9 and ≥6, respectively, comparable to that in healthy controls (men: AUC=0.89; women: AUC=0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC=0.74) and women (AUC=0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified.LIMITATIONS: Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients.CONCLUSIONS: These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.",
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The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons. / Boschloo, Lynn; Vogelzangs, Nicole; Smit, Johannes H; van den Brink, Wim; Veltman, Dick J; Beekman, Aartjan T F; Penninx, Brenda W J H.

In: Journal of Affective Disorders, Vol. 126, No. 3, 11.2010, p. 441-446.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons

AU - Boschloo, Lynn

AU - Vogelzangs, Nicole

AU - Smit, Johannes H

AU - van den Brink, Wim

AU - Veltman, Dick J

AU - Beekman, Aartjan T F

AU - Penninx, Brenda W J H

N1 - Copyright © 2010 Elsevier B.V. All rights reserved.

PY - 2010/11

Y1 - 2010/11

N2 - BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls.METHODS: Data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1756 persons with a past-year depressive and/or anxiety disorder and 648 persons without a lifetime depressive and anxiety disorder. The performance of the AUDIT was compared against the gold standard of a CIDI-based diagnosis of past-year alcohol abuse or dependence by means of sensitivity, specificity and areas under receiver operating characteristic curves (AUCs).RESULTS: The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC=0.89) and women (AUC==0.88), with detected cut-off points of ≥9 and ≥6, respectively, comparable to that in healthy controls (men: AUC=0.89; women: AUC=0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC=0.74) and women (AUC=0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified.LIMITATIONS: Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients.CONCLUSIONS: These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.

AB - BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it to that in healthy controls.METHODS: Data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1756 persons with a past-year depressive and/or anxiety disorder and 648 persons without a lifetime depressive and anxiety disorder. The performance of the AUDIT was compared against the gold standard of a CIDI-based diagnosis of past-year alcohol abuse or dependence by means of sensitivity, specificity and areas under receiver operating characteristic curves (AUCs).RESULTS: The AUDIT accurately detected alcohol dependence in depressed and/or anxious men (AUC=0.89) and women (AUC==0.88), with detected cut-off points of ≥9 and ≥6, respectively, comparable to that in healthy controls (men: AUC=0.89; women: AUC=0.94). However, the overall accuracy in detecting alcohol abuse was limited in depressed/anxious men (AUC=0.74) and women (AUC=0.78) and no adequate cut-off points with both acceptable sensitivity and specificity could be identified.LIMITATIONS: Persons with a primary diagnosis of an addiction disorder were excluded and therefore the sample may not be fully representative of the most severely addicted patients.CONCLUSIONS: These findings confirm the accuracy of the AUDIT in detecting alcohol dependence, but not alcohol abuse, in depressed and/or anxious persons. Screening for alcohol dependence in this high-risk group could improve identification of persons suffering from this impairing comorbid condition.

KW - Adult

KW - Alcoholism/diagnosis

KW - Anxiety Disorders/diagnosis

KW - Comorbidity

KW - Cross-Sectional Studies

KW - Depressive Disorder/diagnosis

KW - Diagnosis, Dual (Psychiatry)

KW - Female

KW - Humans

KW - Male

KW - Mass Screening/statistics & numerical data

KW - Middle Aged

KW - Psychometrics/statistics & numerical data

KW - Reproducibility of Results

KW - Surveys and Questionnaires

U2 - 10.1016/j.jad.2010.04.019

DO - 10.1016/j.jad.2010.04.019

M3 - Article

VL - 126

SP - 441

EP - 446

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 3

ER -