Diagnostic performance of the Alcohol Use Disorders Identification Test (AUDIT) in detecting DSM-5 alcohol use disorders in the General population

Abstract

Objective: The Alcohol Use Disorders Identification Test (AUDIT) is an established screening questionnaire for the detection of at-risk drinking and possible alcohol use disorders (AUD) according to the Diagnostic and Statistical Manual of Mental Disorders - fourth edition (DSM-IV). But there are still no comparable results on the diagnostic performance regarding the new criteria for AUD in the Diagnostic and Statistical Manual of Mental Disorders - fifth edition (DSM-5), especially taking account of possible gender differences. We evaluated the performance of the full AUDIT and the consumption questions (AUDIT-C) in screening for DSM-5 AUD and at-risk drinking.

Method: Data from the study Transitions in Alcohol Consumption and Smoking (TACOS) is used to analyze the area under the receiver-operating characteristic curve, sensitivity, and specificity of the AUDIT and the AUDIT-C in the general population of northern Germany. DSM-5 AUD and at-risk drinking were assessed with the Munich-Composite Diagnostic Interview and used as gold standards.

Results: The best balance between sensitivity and specificity is achieved at a score of 5 for men and 4 for women. High severity, according to DSM-5, were associated with higher cut-offs.

Conclusions: Both AUDIT versions are accurate in the screening for DSM-5 AUD. Since the proposed cut-offs do not differ from the optimal screening cut-offs for DSM-IV disorders, current screening procedures should not face major changes.

Keywords: AUD criteria; AUDIT; Alcohol; Alcohol screening; DSM-5.