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Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
Ask about the substance used, frequency and context of use. The CAGE questionnaire is a useful screening instrument for excessive alcohol use (see ‘Alcohol misuse and dependence’ below).
Cirrhosis
Published in Louisa Baxter, Neel Sharma, Ian Mann, The Junior Doctor’s Guide to Gastroenterology, 2018
Louisa Baxter, Neel Sharma, Ian Mann, Ian Sanderson
Alcohol use – amount, frequency, and type of alcohol ingested, as well as length of time for which the patient has been drinking to excess. Do not accept social’ alcohol intake as an answer. You must be specific. If alcohol misuse is a concern, the CAGE questionnaire may be a useful screening tool, and has been validated to identify alcoholism. Two yes’ responses indicate that the respondent should be investigated further:
Psychiatric comorbidities
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
Jessica M. Donigan, Alexa B. Kimball
The prevalence of alcoholism in psoriasis has been reported to be as high as 18%, greater than that of healthy controls47,48 as well as other dermatological conditions.18 However, study results have been conflicting, likely due to a heterogeneous definition of increased alcohol consumption. Some patients self-medicate with alcohol to decrease anxiety during social situations.1 This can have a further negative impact on patients as excessive alcohol consumption can worsen anxiety and depression. Additionally, excessive alcohol intake can increase pruritus and have a negative impact on sleep quality which can precipitate or worsen psoriasis.29 Once again, this leads to a self-perpetuating problem. Excessive alcohol intake can potentially worsen psoriasis and it also can interact with psoriasis treatments and increase the risk of hepatotoxicity, particularly in the case of methotrexate. It is important to encourage abstinence from alcohol, or at least minimal intake, in these patients. Additionally, the negative impact that alcohol can have on psoriasis in general should be discussed with all patients. It is recommended that patients with a score of two or greater on the CAGE questionnaire (a four question screening test for alcohol abuse) be referred for suspected excessive alcohol consumption.25
A Latent Class Analysis of DUI Offender Motivation and Awareness as Predictors of Performance While on Alcohol Ignition Interlocks
Published in Journal of Substance Use, 2021
Michael Scherer, Kenneth Beck, Eileen P. Taylor, Ann Romosz, Robert Voas, Eduardo Romano
To assess problems associated with alcohol use, participants were given the CAGE questionnaire (Ewing, 1984). The CAGE is a common brief screening tool used to assess problems with alcohol use. The scale has four items – “C” refers to the question if participants have felt they should Cut down on their drinking; “A” refers to whether the participant has been Annoyed by others criticizing their drinking; “G” refers to the item assessing if participants have felt Guilty about their drinking; and “E” refers to whether participants have ever needed an Eye-opener – an alcoholic drink to help them get over the effects of a hangover. The CAGE has demonstrated high temporal stability (α = 0.80–0.95) and adequate correlations with other screening tools assessing (r = .48-.70; Dhalla & Kopec, 2007)
Wellbeing and burnout among medical students in Wales
Published in International Review of Psychiatry, 2019
Sarah Marie Farrell, Andrew Molodynski, Debbie Cohen, Andrew J. Grant, Sarah Rees, Alexandre Wullshleger, Thomas Lewis, Murtaza Kadhum
Thresholds and cut-offs were agreed for the questionnaires prior to the survey opening. A score of 2 or more in the CAGE questionnaire represents a ‘case’ of problem drinking. For the GHQ12, Goldberg and colleagues determined that the appropriate threshold for scores could vary from 1/2 to 6/7 depending upon various factors, with the most common cut-off score used being 2/3 (Goldberg et al., 1997; Goldberg, Oldehinkel, & Ormel, 1998). A score of 2 was therefore selected for this study. Threshold scores for the Oldenburg questionnaire correspond to those on the Maslach Burnout Inventory (MBI) found to best predict physician-diagnosed burnout (Peterson et al., 2008). Using these cut-off scores, burnout was indicated by a score of 2.25 for exhaustion and a score of 2.10 for disengagement; this scoring has been used in recent studies (Westwood, Morison, Allt, & Holmes, 2017).
Alcoholic steatohepatitis (ASH) and alcoholic hepatitis (AH): cascade of events, clinical aspects, and pharmacotherapy options
Published in Expert Opinion on Pharmacotherapy, 2018
Before initiating a therapy in severe AH, its diagnosis has to be validly established also regarding alcohol abuse as cause, best evaluated by canonical tests [99,100]. One of these is the CAGE questionnaire [99], the name of which is the acronym of its four questions that are asked: (1) Have you ever felt you needed to Cut down on your drinking? (2) Have people Annoyed you by criticizing your drinking? (3) Have you ever felt Guilty about drinking? (4) Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover? Two ‘yes’ responses indicate that the possibility of alcoholism should be investigated further. It should presented in details. The questionnaire takes less than one minute to administer and is often used in primary care or other general settings as a quick screening tool rather than as an in-depth interview. Another approach is using the Michigan Alcoholism Screening Test (MAST) [100], which is more complex but generally used by many hepatologists. It is a 25-item scale to assess lifetime symptoms of alcoholism with a focus on late-stage symptoms. Not unexpected, both questionnaire have their limitation and are confronted with issues of validation including sensitivity and specificity, as discussed in the scientific literature [101,102]. To consider these specific issues in more detail is outside of this review article.