Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II
JOHN B SAUNDERS
Centre for Drug and Alcohol Studies, Royal Prince Alfred Hospital, and Departments of Medicine and Psychiatry, University of Sydney, Sydney, Australia
Search for more papers by this authorOLAF G. AASLAND
Ministry of Health and Social Services, Oslo, Norway
Search for more papers by this authorTHOMAS F. BABOR
Alcohol Research Center, Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
Search for more papers by this authorJUAN R. DE LA FUENTE
Institute Mexicano de Psiquiatria, Mexico City, Mexico
Search for more papers by this authorMARCUS GRANT
Programme on Substance Abuse and Mental Health Division, World Health Organization, Geneva, Switzerland
Search for more papers by this authorJOHN B SAUNDERS
Centre for Drug and Alcohol Studies, Royal Prince Alfred Hospital, and Departments of Medicine and Psychiatry, University of Sydney, Sydney, Australia
Search for more papers by this authorOLAF G. AASLAND
Ministry of Health and Social Services, Oslo, Norway
Search for more papers by this authorTHOMAS F. BABOR
Alcohol Research Center, Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
Search for more papers by this authorJUAN R. DE LA FUENTE
Institute Mexicano de Psiquiatria, Mexico City, Mexico
Search for more papers by this authorMARCUS GRANT
Programme on Substance Abuse and Mental Health Division, World Health Organization, Geneva, Switzerland
Search for more papers by this authorAbstract
The Alcohol Use Disorders Identification Test (A UDIT) has been developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10-item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol-related problems. Questions were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
References
- Babor, T. F. & Kadden, R. (1985) Screening for alcohol problems: conceptual issues and practical considerations, in: N. Chang & H. M. Chao, (Eds) Early Identification of Alcohol Abuse. Niaaa Research Monographs No. 17, pp. 1–30 ( Washington , DC , US Government Printing Office).
- Babor, T. F., Ritson, E. B. & Hodgson, R. J. (1986) Alcohol-related problems in the primary health care setting. A review of early intervention strategies. British Journal of Addiction, 81, pp. 23–46.
- Babor, T. F., Kranzler, H. R. & Lauerman, R. J. (1987) Social drinking as a health and psychosocial risk factor: Anstie's limit revisted, in: M. Galanter, (Ed.) Recent Advances in Alcoholism, Vol. 5, pp. 373–402 ( New York , Plenum Press).
10.1007/978-1-4899-1684-6_16 Google Scholar
- Babor, T. F., Weill, J., Treffardier, M. & Bernard, Y. (1988) Detection and diagnosis of alcohol dependence using the Le Go method, in: N. C. Chang & H. M. Chao, (Eds) Early Identification of Alcohol Abuse. NIAAA Research Monograph No. 17 ( Washington , DC , US Government Printing Office).
- Babor, T. F., Kranzler, H. R. & Lauerman, R. J. (1989a) Early detection of harmful alcohol consumption: comparison of clinical, laboratory and self-report screening procedures. Addictive Behaviours, 14, pp. 139–157.
- Babor, T. F., De la Fuente, J. R., Saunders, J. B. & Grant, M. (1989b) AUDIT-The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care ( Geneva , World Health Organization).
- Barrison, I. G., Viola, L., Mumford, J., Murray, R. M., Gordon, M. & Murray-Lyon, I. M. (1982) Detecting excessive drinking among admissions to a general hospital. Health Trends, 14, pp. 80–83.
- Bernadt, W., Mumford, J., Taylor, C., Smith, B. & Murray, R. M. (1982) Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet, i, pp. 325–328.
10.1016/S0140-6736(82)91579-3 Google Scholar
- Bush, B., Shaw, S., Cleary, P., Delbanco, T. L. & Aronson, M. D. (1987) Screening for alcohol abuse using the CAGE questionnaire. American Journal of Medicine, 82, pp. 231–235.
- Chick, J., Kreitman, N. & Plant, M. (1981) Mean cell volume and gamma-glutamyltranspeptidase as markers of drinking in working men. Lancet, i, pp. 1249–1251.
- Cutler, S. F., Wallace, P. G. & Haines, A. P. (1988) Assessing alcohol consumption in general practice patients: a comparison between questionnaire and interview. Alcohol and Alcoholism, 23, pp. 441–450.
- Cyr, M. & Wartman, S. A. (1988) The effectiveness of routine screening questions in the detection of alcoholism. Journal of the American Medical Association, 259, pp. 51–54.
- Edwards, G., Arif, A. & Hodgson, R. (1981) Nomenclature and classification of drug and alcohol related problems: a WHO memorandum. Bulletin of the World Health Organization, 59, pp. 225–242.
- Elvy, G. A. & Wells, J. E. (1984) The Canterbury Alcoholism Screening Test (CAST): a detection instrument for use with hospitalised patients. New Zealand Medical Journal, 97, pp. 111–115.
- Ewing, J. A. (1984) Detecting alcoholism–the Cage questionnaire. Journal of the American Medical Association, 252, pp. 1905–1907.
- Feuerlein, W., Ringer, C., Kufner, H. & Antons, K. (1986) The diagnosis of alcoholism-the Munich Alcoholism Test (MALT). International Journal of Rehabilitation Research, 2, pp. 533–534.
- Garzotto, N., Baratta, S., Pistoso, S. & Faccincani, C. (1988) Validation of a screening questionnaire for alcoholism (Mast) in an Italian sample. Comprehensive Psychiatry, 29, pp. 323–329.
- Gorenc, K.-D., Bruner, C. A., Nadelsticher, A., Pacuruch, S. & Feuerlein, W. (1984) A comparison of German, Spanish and Ecuadorian alcoholics using the Munich Alcoholism Test (MALT). American Journal of Drug and Alcohol Abuse, 10, pp. 429–446.
- Gottesman, I. I. & Prescott, C. A. (1989) Abuses of the MacAndrew MMPI alcoholism scale: a critical review. Clinical Psychology Review, 9, pp. 223–242.
- Hedlund, J. L. & Vieweg, B. W. (1984) The Michigan Alcoholism Screening Test (MAST): a comprehensive review. Journal of Operational Psychiatry, 15, pp. 55–65.
- Institute OF Medicine (1990) Broadening the Base of Treatment for Alcohol Problems ( Washington , DC , National Academy Press).
- Israel, Y., Hurwitz, R., Niemela, O. & Arnon, R. (1986) Monoclonal and polyclonal antibodies against acetaldehyde-containing epitopes in ac-etaldehyde-protein adducts. Proceedings of the National Academy of Sciences of the United States of America, 83, pp. 7923–7967.
- Jacobson, G.R. (1983) Detection, assessment and diagnosis of alcoholism: current techniques, in: M. Galanter, (Ed.) Recent Developments in Alcoholism, pp. 377–413 ( New York , Plenum Press).
- Kapur, B. M. & Israel, I. (1984) Alcohol Dipstick-A Rapid Method for Analysis of Ethanol in Body Fluids ( Toronto , Addiction Research Foundation).
- Klausner, S. Z. & Foulks, E. F. (1982) Eskimo Capitalists: Oil, Politics and Alcohol ( Totowa , NJ , Allanheld Osmun).
- Kristenson, H., Ohlin, H., Hulten-Nosslin, M-B., Trell, E. & Hood, B. (1983) Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24–60 months of long term study with randomized controls. Alcoholism: Clinical and Experimental Research (NY), 7, pp. 203–209.
- Le Go, P. M. (1976) Le Depistage Precoce et Systematique du Buveur Excessif ( Paris , Department ďAlcoologie Therapeutic de Rion Laboratories).
- Macandrew, G. (1965) The differentiation of male alcoholic outpatients from non-alcoholic psychiatric outpatients by means of the MMPI. Quarterly Journal of Studies on Alcohol, 26, pp. 238–246.
- Mayfield, D. G., Mcleod, G. & Hall, P. (1974) The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry, 131, pp. 1121–1123.
- Persson, J. & Magnusson, P. H. (1988) Comparison between different methods of detecting patients with excessive consumption of alcohol. Acta Medica Scandinavica, 223, pp. 101–109.
- Pokorny, A. D., Miller, B. A. & Kaplan, H. B. (1972) The Brief Mast: a shortened version of the Michigan Alcoholism Screening Test. American Journal of Psychiatry, 129, pp. 342–345.
- Room, R. (1988) Cross-cultural research in alcohol studies: research traditions and analytical issues, in: L. H. Towle & T. C. Harford, (Eds) Cultural Influences and Drinking Patterns: A Focus on Hispanic and Japanese Populations. NIAAA Research Monograph No. 19 ( Washington , DC , US Government Printing Office).
- Rosalki, S. B. & RAU, D. (1972) Serum GOT activity in alcoholism. Clinica Chimica Acta, 39, pp. 41–47.
- Ryder, D., Lenton, S., Harrison, S. & Dorricott, J. (1988) Alcohol-related problems in a general hospital and a general practice: screening and the preventive paradox. Medical Journal of Australia, 149, pp. 355–360.
- Saunders, J. B. (1987) The WHO projects an early detection and treatment of harmful alcohol consumption. Australian Drug and Alcohol Review, 6, pp. 303–308.
10.1080/09595238780000751 Google Scholar
- Saunders, J. B. & Aasland, O. G. (1987) WHO Collaborative Project on the Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase I: Development of a Screening Instrument ( Geneva , World Health Organization).
- Saunders, J. B. & Foulds, K. (1992) Brief and early intervention: experience from studies of harmful drinking. Australian and New Zealand Journal of Medicine, 22, pp. 224–230.
- Saunders, W. M. & Kershaw, P. W. (1980) Screening tests for alcoholism: findings from a community study. British Journal of Addiction, 75, pp. 37–41.
- Saunders, J. B., Aasland, O. G., Amundsen, A. & Grant, M. (1993) Alcohol consumption and related problems among primary health care patients. WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption. I. Addiction, 88, pp. 349–362.
- Selzer, M. L. (1971) The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. American Journal of Psychiatry, 127, pp. 1653–1658.
- Selzer, M. L., Vinokur, A. & Van Rooijen, L. (1975) A self-administered Short Michigan Alcoholism Screening Test (SMAST). Journal of Studies on Alcohol, 36, pp. 117–126.
- Skinner, H. A., Holt, S., Schuller R. ROY, J. & Israel, Y. (1984) Identification of alcohol abuse using laboratory tests and a history of trauma. Annals of Internal Medicine, 101, pp. 847–851.
- Skinner, H. A., Ringer, S., Sheu, W. J. & Israel, Y. (1986) Clinical versus laboratory detection of alcohol abuse: the Alcohol Clinical Index. British Medical Journal, 292, pp. 1703–1708.
- Stibler, H., Borg, S. & Joustra, M. (1986) Micro anion exchange chromatography of carbohydrate-deficient transferrin in serum in relation to alcohol consumption. Alcoholism: Clinical and Experimental Research, 10, pp. 535–544.
- Storey, E. L., Anderson, G. J., Mack, U., Powell, L. W. & Halljday, J. W. (1987) Desialated trans-ferrin as a serological marker of chronic excessive alcohol consumption. Lancet, i, pp. 1292–1294.
- Swenson, W. M. & Morse, R. M. (1975) The use of a self-administered alcoholism screenng test (SAAST) in a medical center. Mayo Clinical Proceedings, 50, pp. 204–208.
- Wallace, P., Cutler, S. & Haines, A. (1988) Randemised controlled trial of general practitioner in patients with excessive alcohol consumption. British Medical Journal, 297, pp. 663–668.
- Waterson, E. J. & Murray-Lyon, I. M. (1989) Screening for alcohol related problems in the antenatal clinic: an assessment of different methods. Alcohol and Alcoholism, 24, pp. 21–30.
- Whitfield, J. B., Hensley, W. J., Bryden, D. & Gallagher, H. (1978) Some laboratory correlates of drinking habits. Annals of Clinical Biochemistry, 15, pp. 297–303.
- Wilkins, R. (1974) The Hidden Alcoholic in General Practice ( London , Elek Science).
- World Health Organization (1980) Problems Related to Alcohol Consumption. Report of a WHO Expert Committee. Technical Report Series No. 650 ( Geneva , World Health Organization).
- World Health Organization (1992) International Classification of Diseases, 10th revision, Chap. 5. Mental and Behavioural Disorders due to Psychoactive Substance Use ( Geneva , World Health Organization).
- Wu, A., Chanarin, I. & Levi, A. J. (1974) Macrocytosis of chronic alcoholism. Lancet, i, pp. 829–831.