Questionnaire and biomarker-based risk assessment of alcohol abuse among persons receiving various levels of medical professional education

Abstract

Aim. To compare the results of the questionnaire and biomarker-based risk assessment of alcohol abuse among persons receiving higher and mid-level medical professional education.
 Methods. Among students of mid-level and higher medical education age 18 to 27 years (77 and 124 subjects, respectively), activity of indicator enzymes was measured in blood serum, and with the help of questionnaires the risk of alcohol abuse (CRAFFT, CAGE, AUDIT) and psychological features of the person were determined [A.G. Zverkovs and E.V. Eidmans questionnaires of willpower and self-control, R. Baumeisters self-control questionnaire, hardiness survey (Maddi S.R.) adapted by D.A. Leontyev, Barratt Impulsiveness Scale Test, test for revealing risk groups of psychoactive drug abuse in the educational institution]. Statistical significance was assessed with the use of nonparametric statistics.
 Results. The activity of enzymes (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase) in the blood of the subjects did not have significant intergroup differences. Additionally (beyond this study), we characterized the database of laboratory tests of the students aged 18 to 27 years seeking medical care in the academic center of laboratory diagnosis of Omsk State Medical University. Among 646 subjects, 52 (8.1%) had laboratory analyses exceeding the reference so the differences were expected. Absence of results exceeding reference values of the activity of the studied enzymes was necessary in our study to confirm the absence of pathology associated with cytolysis as well as the signs of chronic alcohol abuse with harmful consequences, which is equivalent to meeting the inclusion criteria (absence of pathology according to medical professional consultation report 086/u and to the results of periodic health examination). Among all surveyed, the CRAFFT questionnaire showed a 2.7-fold higher number of groups at risk of alcohol abuse than CAGE and 1.4 times more than AUDIT. The results of CAGE and CRAFFT test questionnaires showed a greater prevalence of the risk of alcohol abuse among students of higher medical education programs compared to those receiving mid-level medical education (CAGE by 2.7 times; CRAFFT by 1.68 times) . The AUDIT test revealed no statistically significant differences between the groups (p=0.093). Analysis of the results of psychological testing to identify the propensity for addictive behavior, showed a weak correlation with self-control (r=0,406, p=0,014 and r=0,313, p=0,016 for CRAFFT and AUDIT, respectively). Correlation between the self-control violation and risk of alcohol abuse was quite weak according to the results, hence, the students with disordered self-control are not alwaysa characterized by alcohol motivation. In the context of our received data, psychological survey for monitoring the risk of abuse cannot substitute CRAFFT and AUDIT tests.
 Conclusion. The CRAFFT questionnaire is most effective in assessing the risk of alcohol abuse in a population of young people; the results of the questionnaires used weakly correlated with tests that reflect the psychological characteristics of the person; the activity of the studied enzymes in the blood serum of did not correlate with the results of surveys and is within the population reference interval.