Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department

Abstract

Background The use of standard screening methods could improve the detection rate of unhealthy alcohol use in patients admitted to psychiatric acute and emergency departments. The aim of the present study was to investigate the ability of the alcohol biomarker phosphatidylethanol (PEth) to identify patients with high levels of alcohol consumption prior to admission. Methods The data were prospectively collected at admittance to an acute psychiatric department in the period January 2016 to June 2017. A blood sample for the analysis of PEth was available from 177 patients. We compared the PEth concentrations with the Alcohol Use Disorders Identification Test (AUDIT) scores during the hospital stay, and psychiatric diagnoses at discharge. Results A total of 45.8% of the patients had a PEth concentration ≥ 0.03 μmol/L, indicating significant alcohol consumption. AUDIT scores consistent with unhealthy alcohol use were present in 51.7%. There was a significant positive correlation between PEth concentrations and AUDIT scores (r = 0.631, p < 0.001). PEth was above the detection limit of 0.03 μmol/L in 19% of those reporting an average daily intake of zero alcohol units per day during the last week before admission. PEth concentrations were significantly higher among those with an alcohol diagnosis than among those without such a diagnosis (0.82 μmol/L vs. 0.09 μmol/L, p = 0.001). Conclusion PEth provides supplementary information on recent alcohol consumption in a psychiatric population and would be particularly helpful in patients unable or unwilling to give such information at admission.

Falsely low phosphatidylethanol may be associated with biomarkers of haemolytic disease

“…Values of PEth > 0.30 μmol/l 9 and CDT ≥ 1.7% units 19 were considered to represent harmful alcohol consumption. PEth levels of 0.30 μmol/L correspond to approximately 210 ng/ml (exactly 210.9 ng/ml), but as the limit of 0.30 μmol/L is commonly reported, 5 this unit is further used in the present article.…”

“…Advantages of PEth include high sensitivity and specificity, in addition to ability to distinguish between moderate and heavy alcohol consumption. [1][2][3][4][5] Seen in the context of reported alcohol consumption, PEth formation has shown significant variation between individuals. 6 PEth is a group of phospholipids formed by the enzyme phospholipase D (PLD) in the cell membrane of the erythrocytes as direct metabolites of alcohol.…”

“…Phosphatidylethanol (PEth) has become a widely used biomarker for detecting high intake of alcohol, and it is a useful tool for healthcare professionals in assessing harmful alcohol consumption in patients with a variety of diseases and conditions. Advantages of PEth include high sensitivity and specificity, in addition to ability to distinguish between moderate and heavy alcohol consumption 1–5 …”

“…Advantages of PEth include high sensitivity and specificity, in addition to ability to distinguish between moderate and heavy alcohol consumption. 1 , 2 , 3 , 4 , 5 …”

Monitoring of phosphatidylethanol in dried blood spots and of ethyl glucuronide in hair over 6 months of alcohol consumption

“…Nevertheless, the strong correlation between the mean PEth 16:0/18:1 concentration and the AUDIT score is in accordance with the literature. [26][27][28]…”