Development of Screening Questionnaire for Detection of Alcohol Dependence

Abstract

The consumption and acceptability of alcohol in Indian society is increasing [1]. This is reflected in a growing contribution of alcohol to illness and morbidity in both routine and emergency surgical and medical settings [2][3][4][5][6]. Thus it is important that alcohol use disorders (AUD) be recognized in health care settings. One way of quick detection is by the use of screening questionnaires. There are numerous screening questionnaires for detection of AUD such as the well known CAGE (an acronym for Cut down, Annoyed, Guilty feelings and Eye opener) [7], Fast alcohol screening test (FAST) [8], Alcohol use disorders identification test (AUDIT) [9] and others [10]. There is also ample evidence to suggest that screening for AUD is useful and important [11]. However, it is often difficult to administer these instruments in a busy emergency setting because of paucity of time, attitude of the health-care professional, length of time required in administration of the instrument, lack of awareness or unavailability of relevant instruments [12]. Moreover, these instruments have been developed for use in western cultures and the idioms and language used are often not applicable in an Indian context. Some of the instruments used also depend on the quantification of alcohol consumed which may not be relevant to our context given the wide variety of alcohol available locally [13]. Another issue in this area is that of terminology and severity of AUD that the screening questionnaire is designed for. These terminologies range from hazardous and harmful alcohol use to alcohol dependence syndrome (AD) [14,15]. Therefore, there is a need for a simple, culturally sensitive, vernacular screening questionnaire for detection of AUD in an Indian emergency setting. This paper describes the development of a screening questionnaire in the Hindi language for detection of AD for use by doctors in an emergency setting. We have decided to restrict ourselves to the diagnosis of AD as these patients have demonstrable behavioural, social, or health consequences of alcohol use and are in imminent danger of adverse consequences such as complicated withdrawal [16]. As mentioned above, we have designed the questionnaire to be simple, brief and based on behavioural and physiological aspects of alcohol dependence instead of the quantification of alcohol consumed. This questionnaire is designed to screen for presence of the diagnosis of AD or mental and behavioural disorders due to use of alcohol, dependence syndrome, currently using the substance (F10.24) as per the ICD-10 [15]. MAterIAls And MethOdsThis study was conducted in the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh and was approved by the institute ethics committee. All participants provided written informed consent. The study was conducted from May 2013 to July 2013.The items of the questionnaire were derived by consultation among the authors. The items were derived by clinical experience, diagnostic criteria of nosological systems and also relevant ...

Alcohol use disorder research in India: An update

“…[ 245 ] Apart from AUDIT modifications, attempts have been made to develop a vernacular screening instrument for alcohol disorder in emergency settings. [ 246 ] Scales like “Assessment of Recovery Capital” have been translated and validated into Hindi with acceptable scores. [ 247 ]…”