Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-I
This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use...
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| Published in | Addiction (Abingdon, England) Vol. 88; no. 3; pp. 349 - 362 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.03.1993
Blackwell Carfax |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0965-2140 1360-0443 |
| DOI | 10.1111/j.1360-0443.1993.tb00822.x |
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| Abstract | This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol‐related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross‐national use. One thousand, eight hundred and eighty‐eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non‐drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol‐related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol‐related problems scales. There were strong correlations between the various alcohol‐specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol‐related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption. |
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| AbstractList | This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol‐related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross‐national use. One thousand, eight hundred and eighty‐eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non‐drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol‐related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol‐related problems scales. There were strong correlations between the various alcohol‐specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol‐related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption. The aim was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol-related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross-national use. (Original abstract-amended) This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol-related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross-national use. One thousand, eight hundred and eighty-eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non-drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol-related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol-related problems scales. There were strong correlations between the various alcohol-specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol-related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption.This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol-related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross-national use. One thousand, eight hundred and eighty-eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non-drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol-related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol-related problems scales. There were strong correlations between the various alcohol-specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol-related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption. |
| Author | AASLAND, OLAF G. SAUNDERS, JOHN B. GRANT, MARCUS AMUNDSEN, ARVID |
| Author_xml | – sequence: 1 givenname: JOHN B. surname: SAUNDERS fullname: SAUNDERS, JOHN B. organization: Centre for Drug and Alcohol Studies, Royal Prince Alfred Hospital, and Departments of Medicine and Psychiatry, University of Sydney, Sydney, Australia – sequence: 2 givenname: OLAF G. surname: AASLAND fullname: AASLAND, OLAF G. organization: Ministry of Health and Social Services, Oslo, Norway – sequence: 3 givenname: ARVID surname: AMUNDSEN fullname: AMUNDSEN, ARVID organization: National Institute for Alcohol and Drug Research, Olso, Norway – sequence: 4 givenname: MARCUS surname: GRANT fullname: GRANT, MARCUS organization: Programme on Substance Abuse, World Health Organization, Geneva, Switzerland |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4923683$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/8461852$$D View this record in MEDLINE/PubMed |
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| References | Edwards, G. & Gross, M. M. (1976) Alcohol dependence: provisional description of a clinical syndrome, British Medical Journal, i, pp. 1058-1061. Grant, B. F. (1989) DSM-III-R and ICD-10 classification of alcohol use disorders and associated disabilities: a structural analysis, International Review of Psychiatry, 1 pp. 21-39. Hauge, R. & Irgens-Jensen, O. (1986) The relationship between alcohol consumption, alcohol intoxication and negative consequences of drinking in four Scandinavian countries, British Journal of Addiction, 81, pp. 513-524. Moore, R. D., Bone, L. R., Geller, G., Mamon, J., Stokes, E. J. & Levine, D. M. (1989) Prevalence, detection and treatment of alcoholism in hospitalised patients. Journal of the American Medical Association, 261, pp.403-407. Cleary, P. D., Miller, M., Bush, B. T., Warburg, M. M., Delbanco, T. L. & Aronson, M. D. (1988) Prevalence and recognition of alcohol abuse in a primary care population, American Journal of Medicine, 85, pp. 466-471. Drummond, C., Thom, B., Brown, C., Edwards, G. & Mullar, M. J. (1990) Specialist versus general practitioners' treatment of problem drinkers, Lancet, 336, pp. 915-918. Cherpitel, C. J. S. & Rosovsky, H. (1990) Alcohol consumption and casualties: a comparison of emergency room populations in the United States and Mexico, Journal of Studies on Alcohol, 51, pp. 319-326. Robins, L., Wing, J., Wittchen, H. U., Helper, J. E. et al, (1988) The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures, Archives of General Psychiatry, 45, pp. 1069-1077. Babok, T. F., Kranzler, H. R. & Lauerman, R. J. (1989a) Early detection of harmful alcohol consumption: comparison of clinical, laboratory1 and self report screening procedures, Addictive Behaviors, 14, pp. 119-157. National Health AND Medical Research Council (1987) Is There a Safe Level of Daily Alcohol Consumption for Men and Women?, ( Canberra , Australian Government Publishing Service). Redman, S., Cockburn, J., Reid, A. L. A. & Sanson-Fisher, R. W. (1987) Alcohol consumption and alcohol related problems: prevalence amongst a general practice population, Australian Drug and Alcohol Review, 4, pp. 245-252. Saunders, J. B. & Aasland, O. G. (1987) World Health Organization Collaborative Project on the Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase I: Development of a Screening Instrument, ( Geneva , WHO). Le Go, P. M. (1976) Le Depistage Precoce et Systematique du Buvear Excessif, ( Paris , Department d'alcoologie therapeutique de Rion Laboratories). World Health Organization (1992) International Classification of Diseases, 10th revn. Chap. 5, Mental and Behavioural Disorders Due to Psychoactive Substance Use, ( Geneva , WHO). Babor, T. F., DE LA Fuente, J. R., Saundkrs, J. B. & Grant, M. (1989b) AUDIT-The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care, ( Geneva , WHO). Kristenson, H., Ohlin, H., Hulten-Nosslin, M-B., Trell, E. & Hood, B. (1983) Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24-60 months of long term study with randomised controls, Alcoholism: Clinical and Experimental Research, 7, pp. 203-209. Royal College OF General Practitioners (1986) Alcohol: A Balanced View, ( London , RCGP). Kreitman, N. (1986) Alcohol consumption and the prevention paradox, British Journal of Addiction, 81, pp. 353-363. Edwards, G., Arif, A. & Hodgson, R. (1981) Nomenclature and classification of drug-and alcohol-related problems: a WHO memorandum, Bulletin of the World Health Organization, 59, pp. 225-242. Room, R. (1985) Dependence and society, British Journal of Addiction, 80, pp. 133-139. Institute OF Medicine (1990) Broadening the Base of Treatment for Alcohol Problems, ( Washington DC , National Academy Press). Rootman, I. & Moser, J. (1984) Community Response to Alcohol-Related problems. A World Health Organization Monograph, ( Washington , DC , US Department of Health and Human Services). Jellinek, E. M. (1960) The Disease Concept of Alcoholism, (Hillhouse Press). Towle, L. H. & Harford, T. C., (Eds) (1988) Cultural Influences and Drinking Patterns: A Focus on Hispanic and Japanese Populations. NIAAA Research Monograph No.10, ( Washington , DC , United States Government Publishing Office). Nielsen, M. F., Resnick, C. A. & Acuda, S. W. (1989) Alcoholism among outpatients of a rural district general hospital in Kenya, British Journal of Addiction, 84, pp. 1343-1351. Persson, J. & Magnusson, P. H. (1987) Prevalence of excessive or problem drinkers among patients attending somatic outpatient clinics: a study of alcohol related medical care, British Medical Journal, 295, pp. 467-472. Babor, T. F., Ritson, E. B. & Hodgson, R. J. (1986) Alcohol-related problems in the primary health care setting: a review of early intervention strategies, British Journal of Addiction, 81, pp. 23-46. Saunders, J. B. (1986) The WHO international collaborative project on the detection of persons with harmful alcohol consumption, Australian Drug and Alcohol Review, 5, pp. 297-299. Heather, N., Batky, R., Saunders, J. B. & Wodak, A. D. (1990) The Effectiveness of Treatment for Drug and Alcohol Problems: An Overview, ( Canberra , Australian Government Publishing Service). Reid, A. L. A., Webb, G. R., Hennrikus, D., Fahey, P. P. & Sanson-Fisher, R. W. (1986) Detection of patients with high alcohol intake by general practitioners, British Medical Journal, 293, pp. 735-737. World Health Organization (1980) Problems Related to Alcohol Consumption: Report of a WHO Expert Committee, Technical Report Series No. 650 ( Geneva , WHO). 1990; 51 1989; 84 1989; 1 1987; 4 1986; 293 1983; 7 1989a; 14 1976 1985; 80 1989; 261 1989b 1992 1987a 1987; 295 1986; 81 1990; 336 1990 1976; i 1986; 5 1987 1986 1985 1988; 45 1981; 59 1984 1983 1987b; 5 1960 1988; 85 1980 1988 Towle L. H. (e_1_2_1_34_1) 1988 Babor T. F. (e_1_2_1_5_1) 1987 Babor T. F. (e_1_2_1_7_1) 1989 Heather N. (e_1_2_1_14_1) 1990 Edwards G. (e_1_2_1_12_1) 1981; 59 e_1_2_1_23_1 e_1_2_1_24_1 e_1_2_1_21_1 e_1_2_1_27_1 e_1_2_1_28_1 Royal College OF General Practitioners (e_1_2_1_30_1) 1986 e_1_2_1_25_1 e_1_2_1_26_1 Babok T. F. (e_1_2_1_6_1) 1989; 14 National Health AND Medical Research Council (e_1_2_1_22_1) 1987 World Health Organization (e_1_2_1_35_1) 1980 Go P. M. (e_1_2_1_20_1) 1976 Institute OF Medicine (e_1_2_1_16_1) 1990 Rootman I. (e_1_2_1_29_1) 1984 e_1_2_1_31_1 e_1_2_1_8_1 e_1_2_1_3_1 e_1_2_1_13_1 e_1_2_1_10_1 e_1_2_1_33_1 e_1_2_1_2_1 e_1_2_1_11_1 e_1_2_1_17_1 Saunders J. B. (e_1_2_1_32_1) 1987 World Health Organization (e_1_2_1_36_1) 1992 Babor T. F. (e_1_2_1_4_1) 1987 e_1_2_1_15_1 e_1_2_1_9_1 e_1_2_1_18_1 e_1_2_1_19_1 |
| References_xml | – reference: Robins, L., Wing, J., Wittchen, H. U., Helper, J. E. et al, (1988) The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures, Archives of General Psychiatry, 45, pp. 1069-1077. – reference: Towle, L. H. & Harford, T. C., (Eds) (1988) Cultural Influences and Drinking Patterns: A Focus on Hispanic and Japanese Populations. NIAAA Research Monograph No.10, ( Washington , DC , United States Government Publishing Office). – reference: Grant, B. F. (1989) DSM-III-R and ICD-10 classification of alcohol use disorders and associated disabilities: a structural analysis, International Review of Psychiatry, 1 pp. 21-39. – reference: Cherpitel, C. J. S. & Rosovsky, H. (1990) Alcohol consumption and casualties: a comparison of emergency room populations in the United States and Mexico, Journal of Studies on Alcohol, 51, pp. 319-326. – reference: Institute OF Medicine (1990) Broadening the Base of Treatment for Alcohol Problems, ( Washington DC , National Academy Press). – reference: Edwards, G. & Gross, M. M. (1976) Alcohol dependence: provisional description of a clinical syndrome, British Medical Journal, i, pp. 1058-1061. – reference: Royal College OF General Practitioners (1986) Alcohol: A Balanced View, ( London , RCGP). – reference: Kristenson, H., Ohlin, H., Hulten-Nosslin, M-B., Trell, E. & Hood, B. (1983) Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24-60 months of long term study with randomised controls, Alcoholism: Clinical and Experimental Research, 7, pp. 203-209. – reference: Moore, R. D., Bone, L. R., Geller, G., Mamon, J., Stokes, E. J. & Levine, D. M. (1989) Prevalence, detection and treatment of alcoholism in hospitalised patients. Journal of the American Medical Association, 261, pp.403-407. – reference: Saunders, J. B. & Aasland, O. G. (1987) World Health Organization Collaborative Project on the Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase I: Development of a Screening Instrument, ( Geneva , WHO). – reference: World Health Organization (1980) Problems Related to Alcohol Consumption: Report of a WHO Expert Committee, Technical Report Series No. 650 ( Geneva , WHO). – reference: Nielsen, M. F., Resnick, C. A. & Acuda, S. W. (1989) Alcoholism among outpatients of a rural district general hospital in Kenya, British Journal of Addiction, 84, pp. 1343-1351. – reference: Redman, S., Cockburn, J., Reid, A. L. A. & Sanson-Fisher, R. W. (1987) Alcohol consumption and alcohol related problems: prevalence amongst a general practice population, Australian Drug and Alcohol Review, 4, pp. 245-252. – reference: Cleary, P. D., Miller, M., Bush, B. T., Warburg, M. M., Delbanco, T. L. & Aronson, M. D. (1988) Prevalence and recognition of alcohol abuse in a primary care population, American Journal of Medicine, 85, pp. 466-471. – reference: Saunders, J. B. (1986) The WHO international collaborative project on the detection of persons with harmful alcohol consumption, Australian Drug and Alcohol Review, 5, pp. 297-299. – reference: Hauge, R. & Irgens-Jensen, O. (1986) The relationship between alcohol consumption, alcohol intoxication and negative consequences of drinking in four Scandinavian countries, British Journal of Addiction, 81, pp. 513-524. – reference: Edwards, G., Arif, A. & Hodgson, R. (1981) Nomenclature and classification of drug-and alcohol-related problems: a WHO memorandum, Bulletin of the World Health Organization, 59, pp. 225-242. – reference: National Health AND Medical Research Council (1987) Is There a Safe Level of Daily Alcohol Consumption for Men and Women?, ( Canberra , Australian Government Publishing Service). – reference: Kreitman, N. (1986) Alcohol consumption and the prevention paradox, British Journal of Addiction, 81, pp. 353-363. – reference: Room, R. (1985) Dependence and society, British Journal of Addiction, 80, pp. 133-139. – reference: Reid, A. L. A., Webb, G. R., Hennrikus, D., Fahey, P. P. & Sanson-Fisher, R. W. (1986) Detection of patients with high alcohol intake by general practitioners, British Medical Journal, 293, pp. 735-737. – reference: Heather, N., Batky, R., Saunders, J. B. & Wodak, A. D. (1990) The Effectiveness of Treatment for Drug and Alcohol Problems: An Overview, ( Canberra , Australian Government Publishing Service). – reference: Drummond, C., Thom, B., Brown, C., Edwards, G. & Mullar, M. J. (1990) Specialist versus general practitioners' treatment of problem drinkers, Lancet, 336, pp. 915-918. – reference: Le Go, P. M. (1976) Le Depistage Precoce et Systematique du Buvear Excessif, ( Paris , Department d'alcoologie therapeutique de Rion Laboratories). – reference: Babor, T. F., DE LA Fuente, J. R., Saundkrs, J. B. & Grant, M. (1989b) AUDIT-The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care, ( Geneva , WHO). – reference: Babok, T. F., Kranzler, H. R. & Lauerman, R. J. (1989a) Early detection of harmful alcohol consumption: comparison of clinical, laboratory1 and self report screening procedures, Addictive Behaviors, 14, pp. 119-157. – reference: Jellinek, E. M. (1960) The Disease Concept of Alcoholism, (Hillhouse Press). – reference: World Health Organization (1992) International Classification of Diseases, 10th revn. Chap. 5, Mental and Behavioural Disorders Due to Psychoactive Substance Use, ( Geneva , WHO). – reference: Persson, J. & Magnusson, P. H. (1987) Prevalence of excessive or problem drinkers among patients attending somatic outpatient clinics: a study of alcohol related medical care, British Medical Journal, 295, pp. 467-472. – reference: Babor, T. F., Ritson, E. B. & Hodgson, R. J. (1986) Alcohol-related problems in the primary health care setting: a review of early intervention strategies, British Journal of Addiction, 81, pp. 23-46. – reference: Rootman, I. & Moser, J. (1984) Community Response to Alcohol-Related problems. 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| SubjectTerms | Addictive behaviors Adult Adult and adolescent clinical studies Alcohol Drinking - adverse effects Alcohol Drinking - prevention & control Alcohol related problems Alcoholism Alcoholism - diagnosis Alcoholism - epidemiology Alcoholism - prevention & control Biological and medical sciences Cross-Cultural Comparison Cross-Sectional Studies Crossnational studies Female Humans Identification Incidence Male Mass Screening Medical sciences Primary Health Care Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Risk Factors Tropical medicine World Health Organization |
| Title | Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-I |
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