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Identifying alcohol problems among suicide attempters visiting the emergency department

BACKGROUND: Many suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-...

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Autores principales: Lee, Jinhee, Min, Seongho, Ahn, Joung-Sook, Kim, Hyun, Cha, Yong-Sung, Oh, Eugene, Moon, Jin Sil, Kim, Min-Hyuk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842213/
https://www.ncbi.nlm.nih.gov/pubmed/31703656
http://dx.doi.org/10.1186/s12888-019-2347-5
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author Lee, Jinhee
Min, Seongho
Ahn, Joung-Sook
Kim, Hyun
Cha, Yong-Sung
Oh, Eugene
Moon, Jin Sil
Kim, Min-Hyuk
author_facet Lee, Jinhee
Min, Seongho
Ahn, Joung-Sook
Kim, Hyun
Cha, Yong-Sung
Oh, Eugene
Moon, Jin Sil
Kim, Min-Hyuk
author_sort Lee, Jinhee
collection PubMed
description BACKGROUND: Many suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-related biochemical markers and Alcohol Use Disorder Identification Test Consumption (AUDIT-C) in suicide attempters who visited our ED based on the gold standard for clinical diagnosis used by psychiatrists for alcohol use disorder. Moreover, we aimed to search for a significant standard when clinicians make correct predictions about alcohol use disorder using these markers. METHODS: Among the subjects who visited ED following a suicide attempt, a total of 203 subjects were selected. Following a psychiatric interview, the subjects who met the criteria for alcohol abuse or alcohol dependence according to DSM-IV-TR in the past year were defined as the “alcohol use disorder” group. Although some subjects did not meet these criteria, men with a weekly alcohol intake of ≥14 drinks and women with a weekly alcohol intake of ≥7 drinks were classified as the “risky drinking” group. AUDIT-C was used as a self-report; further, aspartate aminotransferase, gamma-glutamyltransferase (GGT), and carbohydrate-deficient transferrin (CDT) were assayed using standard methods, and GGT–CDT was calculated using this formula: 0.8 × ln(GGT) + 1.3 × ln(%CDT). RESULTS: In total, 88 subjects met the criteria for alcohol use disorder and 115 were included in the reference group. In the screening for alcohol use disorder, the AUC of AUDIT-C was 0.89 for men and 0.87 for women. In the screening for risky drinking, the AUC of AUDIT-C was 0.99 for men and 0.93 for women. Compared with other biochemical markers, AUDIT-C showed the highest AUC value for screening for both alcohol use disorder and risky drinking, with the trend being more prominent in men. CONCLUSIONS: Among the biochemical markers, AUDIT-C yielded the highest sensitivity, specificity, and accuracy in diagnosing alcohol use disorder among suicide attempters in ED. Comparison of results revealed that the use of AUDIT-C with biochemical markers or its use alone can help screen for alcohol use disorder or risky drinking in clinical settings.
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spelling pubmed-68422132019-11-14 Identifying alcohol problems among suicide attempters visiting the emergency department Lee, Jinhee Min, Seongho Ahn, Joung-Sook Kim, Hyun Cha, Yong-Sung Oh, Eugene Moon, Jin Sil Kim, Min-Hyuk BMC Psychiatry Research Article BACKGROUND: Many suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-related biochemical markers and Alcohol Use Disorder Identification Test Consumption (AUDIT-C) in suicide attempters who visited our ED based on the gold standard for clinical diagnosis used by psychiatrists for alcohol use disorder. Moreover, we aimed to search for a significant standard when clinicians make correct predictions about alcohol use disorder using these markers. METHODS: Among the subjects who visited ED following a suicide attempt, a total of 203 subjects were selected. Following a psychiatric interview, the subjects who met the criteria for alcohol abuse or alcohol dependence according to DSM-IV-TR in the past year were defined as the “alcohol use disorder” group. Although some subjects did not meet these criteria, men with a weekly alcohol intake of ≥14 drinks and women with a weekly alcohol intake of ≥7 drinks were classified as the “risky drinking” group. AUDIT-C was used as a self-report; further, aspartate aminotransferase, gamma-glutamyltransferase (GGT), and carbohydrate-deficient transferrin (CDT) were assayed using standard methods, and GGT–CDT was calculated using this formula: 0.8 × ln(GGT) + 1.3 × ln(%CDT). RESULTS: In total, 88 subjects met the criteria for alcohol use disorder and 115 were included in the reference group. In the screening for alcohol use disorder, the AUC of AUDIT-C was 0.89 for men and 0.87 for women. In the screening for risky drinking, the AUC of AUDIT-C was 0.99 for men and 0.93 for women. Compared with other biochemical markers, AUDIT-C showed the highest AUC value for screening for both alcohol use disorder and risky drinking, with the trend being more prominent in men. CONCLUSIONS: Among the biochemical markers, AUDIT-C yielded the highest sensitivity, specificity, and accuracy in diagnosing alcohol use disorder among suicide attempters in ED. Comparison of results revealed that the use of AUDIT-C with biochemical markers or its use alone can help screen for alcohol use disorder or risky drinking in clinical settings. BioMed Central 2019-11-08 /pmc/articles/PMC6842213/ /pubmed/31703656 http://dx.doi.org/10.1186/s12888-019-2347-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lee, Jinhee
Min, Seongho
Ahn, Joung-Sook
Kim, Hyun
Cha, Yong-Sung
Oh, Eugene
Moon, Jin Sil
Kim, Min-Hyuk
Identifying alcohol problems among suicide attempters visiting the emergency department
title Identifying alcohol problems among suicide attempters visiting the emergency department
title_full Identifying alcohol problems among suicide attempters visiting the emergency department
title_fullStr Identifying alcohol problems among suicide attempters visiting the emergency department
title_full_unstemmed Identifying alcohol problems among suicide attempters visiting the emergency department
title_short Identifying alcohol problems among suicide attempters visiting the emergency department
title_sort identifying alcohol problems among suicide attempters visiting the emergency department
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842213/
https://www.ncbi.nlm.nih.gov/pubmed/31703656
http://dx.doi.org/10.1186/s12888-019-2347-5
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