Alcohol Use Disorders Identification Test (AUDIT): an updated systematic review of psychometric properties

The Alcohol Use Disorders Identification Test (AUDIT) is an instrument used to screen for alcohol-related problems. It has been increasingly used in many different countries in both the original English-language version and its many translated versions. Because of the need for screening instruments of faster administration, shortened versions of the AUDIT have also been developed. This study was aimed at expanding the work by Berner and colleagues (2007) in an attempt to answer some remaining questions as well as to identify and evaluate studies on the validation of modified versions of the AUDIT, which have not been previously analyzed. In order to do so, we identified indexed articles published between 2002 and 2009 related to the psychometric qualities of the AUDIT by matching the keywords: alcohol, Alcohol Use Disorders Identification Test, and AUDIT. We found 47 articles that evaluated the AUDIT in different countries and in diverse health and community contexts, involving adolescent, adult, and elderly samples. The studies confirmed the validity and efficiency of the AUDIT in the identification of harmful use, abuse, and dependence of alcohol, both in the original version and in modified ones. The possibility of using brief and efficient versions is of great value, since certain health contexts demand faster assessment. The results also showed that the reduced versions have satisfactory psychometric qualities, sometimes with sensitivity values higher than those of the AUDIT itself. The studies analyzed confirm the efficiency of the AUDIT both in its original, reduced, and language-adapted versions in different contexts and cultures.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)(FAEPA) Universidade de São Paulo (USP) - Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Pret

O uso de drogas por motoristas caminhoneiros e o comportamento de risco nas estradas

Justification and Objective: Verify the drugs use by truck drivers and the risk exposure and lifestyle on roads. Since the drugs are increasingly present among truck drivers, and since they are active in transit they need to realize that as a result of bad habits its mandatory not put at risk their health condition and prevent social complications. Method: This is a quantitative, descriptive and exploratory study with 31 drivers of a dairy cooperative. It was applied a questionnaire with 34 questions related to risk exposure and traffic lifestyle and the ASSIST Test. Statistical analyzes were performed by Epi Info®. The significance level used was pJustificativa e objetivos: verificar o uso de drogas por motoristas caminhoneiros e a exposição do risco e o estilo de vida nas estradas. Visto que, as drogas estão cada vez mais presentes entre os caminhoneiros, e, por serem atuante no trânsito, necessita perceber em decorrência dos maus hábitos a necessidade que não o expõem em risco a condição de saúde e evitem complicações sociais. Métodos: trata se de um estudo quantitativo, descritivo e exploratório com 31 motoristas de uma cooperativa de laticínios. Aplicou-se um Questionário elaborado com 34 questões referente à Exposição de Risco e ao Estilo de Vida no Trânsito, e o Teste ASSIST. As análises estatísticas foram realizadas pelo programa estatístico Epi Info®. O nível de significância de

Alcohol Use Disorders (AUD) among Tuberculosis Patients: A Study from Chennai, South India

BACKGROUND: Alcohol Use Disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC), Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India. METHODOLOGY: This is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption. RESULTS: Out of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of <Rs 5000 per month. No females reported alcohol use. Overall, out of 490 TB pts, 29% (141) were found to consume alcohol. Among 141 current drinkers 52% (73) had an AUDIT score of >8. Age (>35 years), education (less educated), income (<Rs 5000 per month), marital status (separated/divorced) and treatment category (Category 2) were statistically significant for TB patients with alcohol use than those TB patients without alcohol use. CONCLUSIONS: AUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care

Validation of screening instruments for depressive disorders and alcohol and tobacco dependence and abuse.

Os transtornos depressivos, a dependência de tabaco e os transtornos relacionados ao uso de álcool (TRUA) são altamente prevalentes e estão associados a diversas comorbidades. Todavia, permanecem subdiagnosticados e subtratados em diversos contextos de saúde. Dessa forma, o presente estudo teve por objetivos: a) avaliar parâmetros de fidedignidade e validade de instrumentos de rastreamento para transtornos depressivos (Patient Health Questionnaire - two itens [PHQ-2] e Well-Being Index - five itens [WHO-5]), dependência de tabaco (Fagerström Test for Nicotine Dependence [FTND] e Heaviness of Smoking Index [HSI]) e de álcool (Fast Alcohol Screening Test [FAST], CAGE, Alcohol Use Disorders Identification Test [AUDIT] e suas versões breves); b) realizar a análise fatorial do WHO-5, FTND e do AUDIT; c) avaliar a comorbidade entre os transtornos supracitados. Participaram dos estudos da fidedignidade teste-reteste 429 universitários e da fidedignidade interavaliadores 41 pacientes do Centro de Atenção Psicossocial - Álcool e Drogas (CAPS-AD). Os estudos da validade preditiva, consistência interna, comorbidade e análise fatorial utilizaram uma amostra de 530 pacientes do Pronto Socorro e do CAPS-AD. A fidedignidade foi estimada por meio do kappa e do coeficiente de correlação intraclasse (CCI). Nos estudos da validade preditiva, a SCID-CV foi a medida diagnóstica comparativa, sendo calculadas as áreas sob a curva ROC (ASC), sensibilidades, especificidades, acurácias, valores preditivos positivos e negativos dos instrumentos. A validade concorrente foi examinada pelo coeficiente de Spearman. O coeficiente alfa de cronbach foi utilizado para aferir a consistência interna. A análise fatorial exploratória foi realizada segundo os critérios de Kaiser. As comorbidades foram avaliadas por meio da regressão logística - odds ratios brutos e ajustados. O nível de significância foi de p0,98). Exibiram, também, consistências internas elevadas (0,76 e 0,78, respectivamente). O WHO-5 obteve uma ASC de 0,89; sensibilidade de 0,85 e especificidade de 0,81 no ponto de corte nove. O PHQ-2 apresentou uma ASC de 0,86; sensibilidade de 0,74 e especificidade de 0,87 no ponto de corte três. O WHO-5 exibiu um único fator que explicou 51% da variância dos dados. Os estudos da fidedignidade do FTND resultaram em altos CCI (0,92 no teste-reteste e 0,99 no interavaliadores). Na análise fatorial, o FTND exibiu dois fatores. A consistência interna do FTND foi elevada (0,83), já a do HSI esteve abaixo do recomendado (0,56). O FTND e o HSI apresentaram elevados valores de sensibilidade, especificidade e acurácia. O AUDIT e suas versões abreviadas apresentaram consistências internas entre 0,83 e 0,94. No estudo da validade preditiva, esses instrumentos exibiram ASC entre 0,92 a 0,96, com índices de sensibilidade entre 0,84 e 0,93; e de especificidade de 0,83 a 0,94 para rastrear TRUA. A menor versão, o AUDIT-3 obteve excelentes resultados. No estudo da validade concorrente, observaram-se correlações expressivas entre as versões breves e o AUDIT (0,91 - 0,99). Em todas as avaliações o CAGE apresentou valores satisfatórios, porém inferiores aos das versões breves do AUDIT. Os resultados obtidos confirmam a validade e a confiabilidade das versões brasileiras do WHO-5, PHQ-2, FTND e do HSI, assim como, a eficácia de todas as versões breves do AUDIT, demonstrando que suas propriedades psicométricas são tão satisfatórias quanto às do instrumento completo e superiores as do CAGE. Portanto, o emprego desses instrumentos encontra apoio em sua viabilidade e sua validade, incentivando a sua utilização tanto na prática clínica diária como em pesquisas. Observou-se, neste estudo, que o tabagismo e o abuso e dependência do álcool são importantes preditores de transtornos depressivos e que os dependentes de álcool mostraram quatro vezes mais chance de serem tabagistas.Depressive disorders, tobacco dependence, and alcohol-related disorders (ARD) are highly prevalent and are associated with several comorbidities. Nonetheless, they are still under-diagnosed and under-treated in many health settings. Therefore, this study was aimed at (1) assessing reliability and validity parameters of screening instruments for depressive disorders (Patient Health Questionnaire 2 [PHQ-2] and Well-Being Index 5 [WHO-5]), tobacco dependence (Fagerström Test for Nicotine Dependence [FTND] and Heaviness of Smoking Index [HSI]), and alcohol dependence (Fast Alcohol Screening Test [FAST], CAGE, Alcohol Use Disorders Identification Test [AUDIT] and their brief versions); (2) performing the factorial analysis of the WHO-5, FTND, and AUDIT; and (3) assessing the comorbidity between the above-mentioned disorders. The test-retest reliability study involved 429 university students and the inter-rater reliability study included 41 patients of a Center for Psychosocial Attention Alcohol and Drugs (CAPS-AD, in the Portuguese acronym). The assessment of the predictive validity, internal consistency, comorbidity, and factorial analysis involved a sample of 530 patients of an emergency unit and the CAPS-AD. Reliability was estimated by means of kappa and interclass correlation (ICC) coefficients. In the predictive validity studies, the SCID-CV was used as the comparison diagnostic measure, with calculation of the areas under the ROC curve (AUC), sensitivity, specificity, accuracy, and positive and negative predictive values of the instruments. Concurrent validity was assessed using Spearmans coefficient. Cronbachs alpha coefficient was used to assess internal consistency. The exploratory factorial analysis was conducted according to Kaisers criteria. Comorbidities were analyzed by logistic regression raw and adjusted odds ratio. The level of statistical significance was set at p 0.98) and internal consistency (0.76 and 0.78, respectively). The WHO-5 had an AUC of 0.89; sensitivity of 0.85; and specificity of 0.81 for a cut-off of 9. The PHQ-2 had an AUC of 0.86; sensitivity of 0.74; and specificity of 0.87 for a cut-off of 3. The WHO-5 yielded one single factor, which explained 51% of the data variance. The reliability study of the FTND provided high ICC coefficients (0.92 for test-retest and 0.99 for inter-rater). In the factorial analysis, the FTND yielded two factors. The internal consistency of the FTND was high (0.83), but that of the HIS was below recommended levels (0.56). The FTND and the HIS had high indices of sensitivity, specificity, and accuracy. The AUDIT and its brief versions had internal consistency values between 0.83 and 0.94. In the study of predictive validity, these instruments had AUC between 0.92 and 0.96, with sensitivity levels between 0.84 and 0.93 and specificity levels ranging from 0.83 and 0.94 for the screening of ARD. The shortest version of the AUDIT (AUDIT-3) had excellent results. In the assessment of concurrent validity, expressive correlations were found between the AUDIT and its brief versions (0.91-0.99). In all analyses, the CAGE had satisfactory results, although inferior to those of the brief versions of the AUDIT. The results confirm the validity and reliability of the Brazilian versions of the WHO-5, PHQ-2, FTND, and HIS, as well as the efficacy of all the brief versions of the AUDIT, demonstrating that their psychometric qualities are as satisfactory as those of the full version of the instrument and superior to those of the CAGE. Therefore, the use of these instruments is supported by their viability and validity, which encourage their use in routine clinical practice and research settings. The results also showed that smoking and alcohol abuse and dependence are important predictors of depressive disorders and that alcoholics had a fourfold higher chance of being smokers

Implicações do uso de álcool, tabaco e outras drogas na vida do universitário

Objective: To assess risk behaviours related to the use of alcohol and other drugs among university students. Methods: Cross-sectional descriptive study, conducted in 2012 in a town of Alto Paranaíba region, in Minas Gerais State, with a sample of 123 university students, who answered questionnaires containing the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Alcohol Use Disorders Identification Test (AUDIT), and the questionnaire on Risk Behaviours Associated with Alcohol and Other Drugs Abuse. Statistical analyses were performed with a significance level of pObjetivo: Verificar las conductas de riesgo relacionadas al consumo del alcohol y otras drogas en los universitarios. Métodos: Estudio descriptivo y transversal realizado em 2012 en un municipio de la Región del Alto de Paranaíba, Minas Gerais, con una muestra de 123 estudiantes universitarios los cuales contestaron a cuestionarios con el teste de Selección del Envolvimiento con el Tabaco, el Alcohol y otras Drogas (ASSIST), el teste para la Identificación de Problemas Relacionados al consumo del Alcohol (AUDIT) y El cuestionario de Conductas de Riesgo Asociadas al abuso del Alcohol y otras drogas. Los análisis estadísticos fueron realizados con el nivel de significación de pObjetivo: Verificar os comportamentos de risco relacionados ao uso de álcool e outras drogas entre universitários. Métodos: Estudo descritivo, transversal, realizado em 2012, em um município da Região do Alto Paranaíba, Minas Gerais, com amostra de 123 estudantes universitários, os quais responderam a questionários contendo o teste para Triagem do Envolvimento com Fumo, Álcool e Outras Drogas (ASSIST), o teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT) e o questionário sobre Comportamentos de Risco Associados ao Abuso de Álcool e Outras Drogas. As análises estatísticas foram realizadas com nível de significância de

Implicações do uso de álcool, tabaco e outras drogas na vida do universitário

Objetivo: Verificar os comportamentos de risco relacionados ao uso de álcool e outras drogas entre universitários. Métodos: Estudo descritivo, transversal, realizado em 2012, em um município da Região do Alto Paranaíba, Minas Gerais, com amostra de 123 estudantes universitários, os quais responderam a questionários contendo o teste para Triagem do Envolvimento com Fumo, Álcool e Outras Drogas (ASSIST), o teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT) e o questionário sobre Comportamentos de Risco Associados ao Abuso de Álcool e Outras Drogas. As análises estatísticas foram realizadas com nível de significância de p<0,05. Resultados: Os resultados do ASSIST indicaram que 50,9% (n=24) dos universitários eram usuários de álcool, 46,2% (n=56) de tabaco e 16,4% (n=4) dos consumidores de maconha apresentaram comportamentos de risco associado ao uso de drogas. Conclusão: O presente estudo constatou, nos universitários investigados, comportamentos de risco relacionados ao uso de álcool e drogas, como envolvimento em acidentes, constrangimento com a lei e ausência de uso de preservativo

Psychometric qualities of the Brazilian versions of the Fagerstrom Test for Nicotine Dependence and the Heaviness of Smoking Index

This study examined the psychometric properties of the Brazilian versions of the Fagerstrom Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI). The test-retest reliability of the FTND was assessed in a sample of 61 smoking university students, with a 15-day interval between assessments. The interrater reliability was examined in 30 smoking patients of a psychosocial care center for alcohol and drug users (PCC-AD). The reliability coefficient was estimated by the kappa and intraclass correlation coefficients. The predictive validity, internal consistency, and factor structure of the FTND and the HSI were evaluated by factor analysis in 271 smokers treated at an emergency unit and at the PCC-AD. The gold standard was the nicotine dependence criteria of DSM-IV, as assessed by the Structured Clinical Interview for DSM-IV. The FTND showed high reliability, with correlation coefficients of .92 for test-retest reliability and .99 for interrater reliability. Both the FTND and the HSI presented high levels of sensitivity and specificity. The internal consistency evaluation yielded a Cronbach`s alpha coefficient of .83 for the FTND and of .56 for the HSI. An exploratory factor analysis found 2 factors in the FTND, which were validated by a confirmatory factor analysis. The results obtained in this study confirm the validity and reliability of the Brazilian versions of the FTND and the HSI

The Brazilian standardization of the MATRICS consensus cognitive battery (MCCB): Psychometric study

Objective: Translate, adapt, and validate the MATRICS Consensus Cognitive Battery (MCCB) in Brazil. Method: The present study followed three steps: 1) translation to Portuguese, cultural adaptation, and back translation to English2) completion of a pilot study (N = 30) conducted with the purpose of assessing whether the general comprehension of the items was clear and all participants adequately responded to the battery3) completion of a Reliability and Validation Study of the Brazilian version of the MCCB with 99 individuals with schizophrenia and 99 healthy subjects. All participants were administered the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and patients were also rated on the Global Assessment of Functioning (GAF) Scale and the Positive and Negative Symptoms Scale (PANSS). Results: The results showed adequate to high levels of baseline and 4-week retest reliability, except the MSCEIT-MEadequate internal consistency for the MSCEIT-ME for the total sample and patients group, and moderate Alpha for the health control sampleas well as evidence of convergent validity and sensitivity to differentiate performance between the groups. All the 10 MCCB measures showed the lowest learning effects. Conclusion: Overall the Brazilian version of the MCCB showed similar results to the original North American version. Our findings provides reassurance that the MCCB is a reliable and valid measure of cognition across different countries and cultures, which is especially important to the ongoing work in attempting to discover cognition enhancing drugs and the effects of cognitive interventions for the treatment of schizophrenia. (C) 2017 Elsevier B.V. All rights reserved.FAPESPUniv Fed Sao Paulo Unifesp, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, Dept Psychiat, Schizophrenia Program PROESQ, Sao Paulo, BrazilCtr Univ FIEO, Strict Sensu Educ Psychol Program, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Calif Los Angeles, Dept Psychiat & Biobehav Sci, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Calif Los Angeles, Dept Psychol, 300 UCLA Med Plaza,Room 2240, Los Angeles, CA 90095 USAUniv Fed Sao Paulo Unifesp, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, Dept Psychiat, Schizophrenia Program (PROESQ), BrazilFAPESPWeb of Scienc

Is the Full Version of the AUDIT Really Necessary? Study of the Validity and Internal Construct of Its Abbreviated Versions

Background: This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults. Methods: The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearson`s correlation coefficient. Results: The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbach`s alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments. Conclusions: The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Brazil)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brazil)Fundacao de Apoio ao Ensino (FAEPA)Pesquisa e Assistencia do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto daUniversidade de Sao Paulo (FAEPA, Brazil

The Fast Alcohol Screening Test (FAST) is as Good as the AUDIT to Screen Alcohol Use Disorders

This study was aimed at assessing the psychometric qualities of the fast alcohol screening test (FAST), and at comparing these qualities to those of the alcohol use disorders identification test (AUDIT) in three samples of Brazilian adults: (i) subjects attended at an emergency department (530); (ii) patients from a psychosocial care center (40); and (iii) university students (429). The structured clinical interview for diagnosis (SCID)-IV was used as gold standard. The FAST demonstrated high test-retest and interrater reliability coefficients, as well as high predictive and concurrent validity values. The results attest the validity and reliability of the Brazilian version of the FAST for the screening of indicators of alcohol abuse and dependence