Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-24T17:20:09.427Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of investigations in the diagnosis and management of alcohol use disorders

Published online by Cambridge University Press:  02 January 2018

Colin Drummond  and
Hamid Ghodse
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The purpose of this review is to familiarise the reader with the clinical utility of investigations in the diagnosis and management of alcohol use disorders (AUDs). Many biochemical and haematological tests are widely available, and can improve significantly the quality of diagnosis and management. However, there is no single test that can detect AUDs with complete accuracy. Further, the validity of a test will vary depending on the clinical application. Such tests should never be relied on in isolation. Adequate clinical evaluation also needs to include a combination of interview and examination of the patient, and interview of other informants (Cantwell & Chick, 1994; Edwards et al, 1997). In the research setting, self-report is generally a valid and reliable method of assessing alcohol consumption (Babor et al, 1987), particularly when it is elicited by a standardised method (e.g. Sobell et al, 1980) and the information is provided in confidence. In the clinical setting, however, the patient may report his or her version of past drinking subject to the demand characteristics of the situation, particularly if adverse consequences are likely to ensue (e.g. discharge from a treatment programme).

Type
Research Article
Information
Advances in Psychiatric Treatment , Volume 5 , Issue 5 , September 1999 , pp. 366 - 375
Copyright
Copyright © The Royal College of Psychiatrists 1999 

References

Anton, R. F. & Moak, D. H. (1994) Carbohydrate deficient transferrin and gamma glutamyl transferase as markers of heavy alcohol consumption: gender differences. Alcoholism: Clinical and Experimental Research, 18, 747–754.CrossRefGoogle ScholarPubMed
Babor, T. F., Stephens, R. S. & Marlatt, G. A. (1987) Verbal report methods in clinical research on alcoholism: response bias and its minimisation. Journal of Studies on Alcohol, 48, 410–424.Google Scholar
Bates, M. E. & Martin, C. S. (1997) Immediate, quantitative estimation of blood alcohol concentration from saliva. Journal of Studies on Alcohol, 58, 531–538.CrossRefGoogle ScholarPubMed
Bell, H., Tallaksen, C. M., Try, K. et al (1994) Carbohydrate deficient transferrin and other markers of high alcohol consumption: a study of 502 patients admitted consecutively to a medical department. Alcoholism: Clinical and Experimental Research, 18, 1103–1108.CrossRefGoogle ScholarPubMed
* Cantwell, R. & Chick, J. (1994) Alcohol misuse: clinical features and treatment. In Seminars in Alcohol and Drug Misuse (eds Chick, J. & Cantwell, R.) pp. 126–155. London: Gaskell.Google Scholar
* Chick, J., Badawy, A. & Borg, S. (1993) Identification of excessive drinking and alcohol problems. Alcohol and Alcoholism, suppl. 2, 121–125.Google Scholar
Dinan, T. & O'Flynn, K. (1994) Medical aspects of drug and alcohol abuse. In Seminars in Alcohol and Drug Misuse (eds Chick, J. & Cantwell, R.) pp. 202–222. London: Gaskell.Google Scholar
* Edwards, G., Marshall, E. J. & Cook, C. C. H. (1997) The Treatment of Drinking Problems: A Guide for the Helping Professions (3rd edn). Cambridge: Cambridge University Press.Google Scholar
Enghusen-Poulsen, H., Loft, S., Andersen, J. R. et al (1992) Disulfiram therapy: adverse drug reactions and interactions. Acta Psychiatrica Scandanavica, 369, 59–65.CrossRefGoogle ScholarPubMed
Estruch, R. (1996) Alcohol and nutrition. In Alcohol Misuse: A European Perspective (ed. Peters, T. J.) Amsterdam: Harwood.Google Scholar
Farrell, M. P. & David, A. S. (1988) Do psychiatric registrars take a proper drinking history? British Medical Journal, 296, 395–396.CrossRefGoogle Scholar
Holford, N. G. H. (1987) Clinical pharmacokinetics of ethanol. Clinical Pharmacokinetics, 13, 273–292.Google Scholar
Jones, A. W. (1995) Pharmacokinetics of ethanol. In Encyclopaedia of Drugs and Alcohol (ed. Jaffe, J. H.) vol. 2, pp. 803–808. London: Macmillan Library Reference.Google Scholar
Keating, J., Cheung, C., Peters, T. J. et al (1998) Carbohydrate deficient transferrin in the assessment of alcohol misuse: absolute or relative measurements? A comparison of two methods with regard to total transferrin concentration. Clinica Chimica Acta, 272, 159–169.CrossRefGoogle ScholarPubMed
* Leigh, G. & Skinner, H. A. (1988) Physiological assessment. In Assessment of Addictive Behaviours: A Reference Book for the Caring Professions (eds Donovan, D. M. & Marlatt, G. A.) pp. 112–136. London: Hutchinson.Google Scholar
* Marshall, W. J. & Bangert, S. K. (eds) (1995) Clinical Biochemistry: Metabolic and Clinical Aspects. London: Churchill Livingstone.Google Scholar
Mayfield, D., McLeod, G. & Hall, P. (1974) The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry, 131, 1121–1123.Google Scholar
Miller, W. R. & Rollnick, S. (1991) Motivational Interviewing: Preparing People to Change Addictive Behaviour. New York: Guilford Press.Google Scholar
Mitchell, C., Simpson, D. & Chick, J. (1997) Carbohydrate deficient transferrin in detecting relapse in alcohol dependence. Drug and Alcohol Dependence, 48, 97–103.Google Scholar
Rosman, A. S., Basu, P., Galvin, K. et al (1995) Utility of carbohydrate deficient transferrin as a marker of relapse in alcoholic patients. Alcoholism: Clinical and Experimental Research, 19, 611–616.Google Scholar
* Saunders, J. B., Aasland, O. G., Amundsen, A. et al (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, 349–362.Google Scholar
Schmidt, L. G., Schmidt, K., Dufeu, P. et al (1997) Superiority of carbohydrate deficient transferrin to gamma glutamyltransferase in detecting relapse in alcoholism. American Journal of Psychiatry, 154, 75–80.Google Scholar
Sellers, E. M. & Kalant, H. (1976) Alcohol intoxication and withdrawal. New England Journal of Medicine, 294, 757–762.Google Scholar
Selzer, M. L. (1971) The Michigan alcoholism screening test: the quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653–1658.Google Scholar
Skinner, H. A., Holt, S., Schuller, R. et al (1985) Identification of alcohol abuse: trauma and laboratory indicators. In Early Identification of Alcohol Abuse (eds Chang, N. C. & Chao, H. M.) NIAAA Research Monograph No 17, pp. 285–302. National Institute of Alcohol Abuse and Alcoholism, Washington DC: Government Printing Office.Google Scholar
Sobell, M. B., Maisto, S. A., Sobell, L. C. et al (1980) Developing a prototype for evaluating alcohol treatment effectiveness. In Evaluating Alcohol and Drug Abuse Treatment Effectiveness: Recent Advances (eds Sobell, L. C., Sobell, M. B. & Ward, E.) pp. 129–150. New York: Pergamon.CrossRefGoogle Scholar
Sorvajarvi, K., Blake, J. E., Israel, Y. et al (1996) Sensitivity and specificity of carbohydrate deficient transferrin as a marker of alcohol abuse are significantly influenced by alterations in serum transferrin: a comparison of two methods. Alcoholism: Clinical and Experimental Research, 20, 449–454.CrossRefGoogle ScholarPubMed
Stibler, H. (1991) Carbohydrate deficient transferrin in serum: a new marker of potentially harmful alcohol consumption reviewed. Clinical Chemistry, 37, 2029–2037.CrossRefGoogle ScholarPubMed
Viitala, K., Lahdesmaki, K. & Niemela, O. (1998) Comparison of the Axis %CDT TIA and the CDTect method as laboratory tests for alcohol abuse. Clinical Chemistry, 44, 1209–1215.CrossRefGoogle ScholarPubMed
Wright, C., Vafier, J. A. & Lake, C. R. (1988) Disulfiraminduced fulminating hepatitis: guidelines for liver panel monitoring. Journal of Clinical Psychiatry, 49, 430–434.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.