An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking.
An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking.
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DOI：
10.1186/s12913-022-08408-1
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发表时间：
2022-09-05
影响因子：
2.8
通讯作者：
Hallgren, Kevin A.
中科院分区：
文献类型：
--
作者：
Ryan, Emma D.;Chang, Yanni M.;Oliver, Malia;Bradley, Katharine A.;Hallgren, Kevin A.
尽管酒精使用障碍会使抑郁症的治疗变得复杂，但对于抑郁症筛查呈阳性的患者，初级保健中没有评估 AUD 症状（即 AUD 诊断标准）的标准流程。这项研究描述了初级保健患者在常规护理筛查措施中报告的抑郁症状与高风险饮酒之间的关联。然后，本研究利用一项新的临床项目的数据，通过酒精症状检查表描述了初级保健高风险饮酒患者报告的抑郁症状和 AUD 症状之间的关联。在这项横断面研究中，电子健康记录数据来自于 2018 年 3 月至 2020 年 2 月期间访问过 33 个 Kaiser Permanente 华盛顿初级保健诊所并在常规护理中完成抑郁症 (PHQ-2) 和饮酒 (AUDIT-C) 筛查措施的患者 (N = 369,943)。报告高风险饮酒（AUDIT-C 评分 7-12）的患者还完成了一份酒精症状检查表，其中报告了是否存在 DSM-5 定义的 11 项 AUD 标准（N = 8,184）。广义线性模型估计并比较了有或没有阳性抑郁筛查的患者的高风险饮酒（AUDIT-C 评分 7-12）和可能的 AUD（酒精症状检查表上的 2-11 AUD 症状）的患病率。抑郁症筛查呈阳性的患者的高风险饮酒患病率比筛查呈阴性的患者高 131%（5.2% vs. 2.2%；p<0.001）。在高风险饮酒患者中，抑郁筛查阳性与显着较高的可能 AUD 患病率相关（69.8% vs. 48.0%；p< 0.001），随着 PHQ-2 评分的增加，观察到的可能 AUD 患病率存在很大差异（例如，对于 PHQ-2 评分，可能 AUD 患病率分别为 37.6%、55.3% 和 65.2%）分别为 0、1 和 2）。尽管男性患者高风险饮酒的总体患病率较高，但男性和女性患者的抑郁筛查、高风险饮酒和 AUD 症状之间的关联模式相似。抑郁筛查呈阳性的患者更有可能有高风险饮酒。当有机会使用酒精症状检查表时，很大比例的抑郁症筛查呈阳性和高风险饮酒的患者会向医疗保健提供者报告与 AUD 一致的症状。在线版本包含可在 10.1186/s12913-022-08408-1 获取的补充材料。
Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive symptoms and high-risk drinking reported by primary care patients on screening measures in routine care. Then, using data from a novel clinical program, this study characterizes the association between depressive symptoms and AUD symptoms reported by primary care patients with high-risk drinking via an Alcohol Symptom Checklist. In this cross-sectional study, electronic health record data were obtained from patients who visited 33 Kaiser Permanente Washington primary care clinics between 03/2018 and 02/2020 and completed depression (PHQ-2) and alcohol consumption (AUDIT-C) screening measures as part of routine care (N = 369,943). Patients who reported high-risk drinking (AUDIT-C scores 7–12) also completed an Alcohol Symptom Checklist where they reported the presence or absence of 11 AUD criteria as defined by the DSM-5 (N = 8,184). Generalized linear models estimated and compared the prevalence of high-risk drinking (AUDIT-C scores 7–12) and probable AUD (2–11 AUD symptoms on Alcohol Symptom Checklists) for patients with and without positive depression screens. Patients who screened positive for depression had a 131% higher prevalence of high-risk drinking than those who screened negative (5.2% vs. 2.2%; p < 0.001). Among patients with high-risk drinking, positive depression screens were associated with a significantly higher prevalence of probable AUD (69.8% vs. 48.0%; p < 0.001), with large differences in the prevalence of probable AUD observed with increasing PHQ-2 scores (e.g., probable AUD prevalence of 37.6%, 55.3% and 65.2%, for PHQ-2 scores of 0, 1, and 2, respectively). Although the overall prevalence of high-risk drinking was higher for male patients, similar patterns of association between depression screens, high-risk drinking, and AUD symptoms were observed for male and female patients. Patients with positive depression screens are more likely to have high-risk drinking. Large percentages of patients with positive depression screens and high-risk drinking report symptoms consistent with AUD to healthcare providers when given the opportunity to do so using an Alcohol Symptom Checklist. The online version contains supplementary material available at 10.1186/s12913-022-08408-1.
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DOI：
10.1097/01.alc.0000164374.32229.a2
发表时间：
2005-05-01
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Dawson, DA;Grant, BF;Zhou, Y
通讯作者：
Zhou, Y
影响因子：
158.5
作者：
Anton, Raymond F.
通讯作者：
Anton, Raymond F.
影响因子：
3.8
作者：
Akincigil, Ayse;Matthews, Elizabeth B.
通讯作者：
Matthews, Elizabeth B.
影响因子：
7.2
作者：
Glass, Joseph E.;Bobb, Jennifer F.;Bradley, Katharine A.
通讯作者：
Bradley, Katharine A.
影响因子：
--
作者：
Bush, K;Kivlahan, DR;Bradley, KA
通讯作者：
Bradley, KA