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Diagnosis of alcoholism

There are several ways to detect and diagnose alcoholism or alcohol abuse. In general it is easier to detect alcoholism in men than in women. Stigmatization fear may be one reason for women to deny that they drink and suffer from alcohol related medical condition (and women usually drink alone), which is less of a problem in men who tend to drink in group and more easily accept that they drink and may have an alcohol related medical condition. As a result, it may be more difficult to detect alcoholism and alcohol related medical condition among women.

Screening to detect alcoholism:

A commonly used technique to detect alcoholism is to give a questionnaire form (known as CAGE questionnaire and named after the four questions asked in the questionnaire) to individuals. With the help of CAGE questionnaire, it is possible to quickly screen patients visiting doctor’s clinic. The CAGE questionnaire has shown to be very effective and sensitive in detecting alcohol related problems, although it has limitation in detecting alcohol related medical problems among women, college students and individuals with less severe alcohol related problems.

The following for questions are asked in CAGE questionnaire:

  1. Have you ever felt that you need to Cut down your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt any Guilt about your drinking?
  4. Have you ever felt the need of a drink first in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Two or more “yes” responses require further investigation.

There are also other methods of screening for detecting alcoholism such as “Alcohol Dependence Data Questionnaire”, MAST (Michigan Alcohol Screen Test), “Alcohol Use Disorders Identification Test” or AUDIT, a screening questionnaire developed by the WHO (World Health Organization) and is accepted worldwide.

There are some reliable tests (such as blood alcohol content) to detect alcohol use, but these tests can not differentiate alcoholics from non alcoholics. Long term alcohol abuse produce following in alcohol abusers, which are not seen in occasional drinkers:

  • Macrocytosis
  • Elevated Gamma Glutamyl Transpeptidase (GGT).
  • AST: ALT ratio of 2:1
  • High carbohydrate deficient transferrin.

Any of these laboratory value changes are not as sensitive as that of screening questionnaire, such as CAGE questionnaire and Alcohol Use Disorders Identification Test by World Health Organization.

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1 Comment

  • Ned Wicker July 06, 2011 05.09 pm

    Good post and the only thing I would add is that if someone THINKS they have an alcohol problem they probably do have an issue. Whether one is an ALCOHOLIC is subjective, but that alcohol is bad for you is not.

    If you think you might have a problem seek treatment from your doctor and get more information. Problems with alcohol rarely go away on there own.

    Reply 

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