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Introduction: The aim of this study was to test whether brief alcohol interventions at general hospitals work equally well for males and females and across age-groups. Methods: The current study includes a reanalysis of data reported in the PECO study (testing delivery channels of individualized motivationally tailored alcohol interventions among general hospital patients: in PErson vs. COmputer-based) and is therefore of exploratory nature. At-risk drinking general hospital patients aged 18–64 years (N = 961) were randomized to in-person counseling, computer-generated individualized feedback letters, or assessment only. Both interventions were delivered on the ward and 1 and 3 months later. Follow-ups were conducted at months 6, 12, 18, and 24. The outcome was grams of alcohol/day. Study group × sex and study group × age interactions were tested as predictors of change in grams of alcohol/day over 24 months in latent growth models. If rescaled likelihood ratio tests indicated improved model fit due to the inclusion of interactions, moderator level-specific net changes were calculated. Results: Model fit was not significantly improved due to the inclusion of interaction terms between study group and sex (χ2[6] = 5.9, p = 0.439) or age (χ2[6] = 5.5, p = 0.485). Discussion: Both in-person counseling and computer-generated feedback letters may work equally well among males and females as well as among different age-groups. Therefore, widespread delivery of brief alcohol interventions at general hospitals may be unlikely to widen sex and age inequalities in alcohol-related harm. [ABSTRACT FROM AUTHOR]

Background and aims: Evidence for efficacy of brief alcohol interventions (BAIs) is mainly limited to primary care and at‐risk drinkers. The aim was to test the efficacy of a BAI addressing the full spectrum of alcohol use in a general population sample and across alcohol risk groups. Design Two‐parallel‐group randomized controlled trial (allocation ratio 1:1) with post‐baseline assessments at months 3, 6 and 12. Setting: One municipal registry office in Germany responsible for registration, passport and vehicle admission issues. Participants: A total of 1646 proactively recruited 18–64‐year‐old adults with past year alcohol use (56% women, 66% low‐risk drinkers) were randomized to intervention (n = 815) or control (n = 831). Intervention and comparator: The intervention consisted of assessment plus computer‐generated individualized feedback letters at baseline and months 3 and 6. Comparator was assessment only. Measurements Primary outcome was change in the self‐reported number of drinks/week from baseline to 12 months. Changes at 3 and 6 months were secondary outcomes. Moderator was alcohol risk group (low‐risk versus at‐risk drinking) according to the Alcohol Use Disorders Identification Test–Consumption, with scores from 1‐3 (women) and from 1‐4 (men) indicating low‐risk drinking. Findings For the whole sample, significant group differences were observed neither at 12‐month follow‐up [incidence rate ratio (IRR) = 1.01, 95% confidence interval (CI) = 0.87–1.17, Bayes factor (BE) = 0.52] nor at previous assessments (month 3: IRR = 1.01, 95% CI = 0.92–1.12, BE = 0.41; month 6: IRR = 0.93, 95% CI = 0.81–1.07, BE = 1.10). Moderator analyses revealed that low‐risk drinkers were more likely to benefit from BAI only at month 6 than at‐risk drinkers (IRR = 0.77, 95% CI = 0.70–0.86). Conclusions: In a randomized controlled trial, there was no clear evidence for efficacy of a computer‐based brief alcohol intervention in a general population sample, but there was some evidence of medium‐term benefits in the large but understudied group of low‐risk drinkers. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Do in-person and computer-based brief alcohol interventions reduce tobacco smoking among general hospital patients? Secondary outcomes from a randomized controlled trial." The correction states that the first names and family names of all authors need to be exchanged. The correct author names are Filipa Krolo-Wicovsky, Sophie Baumann, Anika Tiede, Gallus Bischof, Ulrich John, Beate Gaertner, and Jennis Freyer-Adam. The original publication has been corrected. The publisher, Springer Nature, remains neutral regarding jurisdictional claims and institutional affiliations. [Extracted from the article]

Underreporting of alcohol consumption is one of the major challenges in survey research including self-reports. The aim of this study was to test whether underreporting can be reduced by prompting respondents to first reflect on their drinking in the past week and then answer quantity-frequency based screening questions on their typical alcohol use. Data come from 2,379 adults (54% female; mean age = 31.8 years, SD = 11.4 years) consecutively recruited at a local registration office in northeastern Germany. Participants responded to an electronic, self-administered questionnaire on different health behaviors. They were randomized to receiving the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) either before or after the assessment of past week timeline follow-back questions. Logistic regression models were calculated predicting positive screening results for at-risk drinking. Potential interaction effects with gender, age and educational background were explored. Results show that the assessment of past week alcohol consumption prior to the assessment of the AUDIT-C reduced the odds of obtaining positive screening results (OR = 0.83; 95% CI = 0.70–0.99). There were no interaction effects with gender, age and educational background. As a secondary finding, participants reported consistently lower alcohol consumption in the alcohol measure that was administered later in the questionnaire. Preceding questions about alcohol consumption in the past week reduced the probability of positive screening results for at-risk drinking. Our findings suggest that prompting people to recall past week alcohol use prior to screening may not be a solution to reduce underreporting. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to test whether the efficacy of in-person and computer delivered brief alcohol intervention (BAI) is moderated by mental health status. Method: General hospital inpatients with at-risk alcohol use aged 18 to 64 years (N = 961, 75% men) were allocated to in-person BAI, computer-based BAI, and assessment only. In-person BAI contained counseling by research staff. Computer-based BAI contained computer-generated individualized feedback letters. BAIs were designed to be delivered at baseline and 1 and 3 months later. Outcome was reduction in alcohol use per day after 6, 12, 18, and 24 months. Latent growth curve models were estimated. Two mental health indicators, the 5-item mental health inventory and routine care diagnosis of mental and behavioral disorders assessed by general hospital physicians, were tested as moderators of BAI efficacy. Results: In all groups, inpatients with better mental health reduced alcohol use after hospitalization (ps < 0.01). While inpatients with impaired mental health did not reduce their drinking significantly following assessment only, those who received any of the 2 BAIs did (ps < 0.05). Conclusions: BAI was particularly efficacious in reducing alcohol use among general hospital inpatients with at-risk alcohol use and impaired mental health, with computer-based delivery being at least as efficacious as in-person delivery. [ABSTRACT FROM AUTHOR]

Aims To investigate whether or not a stage tailored intervention is more effective than a non-stage tailored intervention of the same intensity in reducing alcohol use among job-seekers with unhealthy alcohol use, and whether initial motivation to change is a moderator of efficacy. Design A three-group randomized controlled trial with 3-, 6- and 15-month follow-ups. Setting Three job agencies in Germany. Participants A total of 1243 job-seekers with unhealthy alcohol use were randomized to (i) stage tailored intervention based on the transtheoretical model of change ( ST), (ii) non-stage tailored intervention based on the theory of planned behaviour ( NST) and (iii) assessment only (controls). Participants received feedback letters and manuals at baseline and 3 months later. Measurements Piecewise latent growth models were calculated measuring change in 'alcohol use' from baseline to month 3 (active intervention phase) and from months 3 to 15 (post-intervention phase, primary outcome). Motivation to change was included as a 4-point continuous measure. Findings All groups reduced alcohol use from months 0 to 3 (controls: mean = −0.866, NST: mean = −0.883, ST: mean = −0.718, Ps ≤ 0.001). Post-intervention (months 3-15), low-motivated individuals in the ST group showed a greater reduction than those in the control group (β = 0.135, P = 0.039, Cohen's d = 0.42) and in the NST group (β = 0.180, P = 0.009, Cohen's d = 0.55). In contrast, compared to the ST group (β = 0.030, P = 0.361), alcohol use decreased more strongly with higher initial motivation in the NST group (β = −0.118, P = 0.010). Conclusions Among job-seekers with high levels of alcohol consumption, an intervention tailored to motivational 'stage of change' was more effective than a non-stage tailored intervention for reducing alcohol use 15 months after baseline assessment in participants with low initial motivation to change. [ABSTRACT FROM AUTHOR]

Aims: Previous studies investigating dose-response relations between volume of drinking and diseases have focused on single diseases only. Until now, the relation between the drinking volume and the risk of having any alcohol-attributable disease is largely unknown. The aim of the present study is to investigate to what extent is the risk of diseases with different alcohol-attributable fractions (AAFs) predicted by daily alcohol consumption (>120 g, 61-120 g vs 31-60 g). Methods: The sample consisted of 805 inpatients classified as at-risk drinking, aged 18-64 years hailing from four general hospitals in North-eastern Germany. Inpatients were classified into three groups (AAF = 1, AAF < 1, AAF = 0). Group differences regarding alcohol-related variables, smoking, and demographics were analysed. A multinomial logistic regression analysis was conducted to predict the risk of diseases with AAF = 1 and AAF < 1. Results: In our sample, 26.6% of the inpatients showed a disease with AAF = 1, while 20.2% had a disease with AAF < 1. Inpatients consuming >120 g, and inpatients consuming 61-120 g revealed significantly higher odds for diseases with AAF = I compared to inpatients consuming 31-60 g (OR = 6.30, CI = 3.55-11.26; OR = 2.91, CI = 1.64-5.13). Regarding diseases with AAF < 1, inpatients consuming >120 g revealed significantly higher odds compared to the inpatients consuming 31-60 g (OR = 1.97, CI = 1.15-3.37). Conclusions: A dose-response relation between the level of the drinking volume and the risk of diseases with AAF = 1 was found in this sample of inpatients from the general hospitals. [ABSTRACT FROM AUTHOR]

Aims Previous studies have found that abstainers utilize out-patient health services more than alcohol consumers. The aim of this study was to investigate this relationship further by including several confounding variables and effect modifiers. It was hypothesized that abstainers utilize more health services because they have less social resources, practice more risky health behaviours, have poorer self-reported health and suffer more from chronic diseases. Design and participants Cross-sectional health survey of a random sample of adults aged 20–64 in Pomerania, Germany. The response rate was 68.8%. Alcohol consumption was assessed using a quantity–frequency measure and categorized into past-year abstainers, low-risk, medium-risk and high-risk drinkers. Confounders and effect modifiers included socio-demographic and health-related variables. Findings Abstainers had a 43% higher rate (rate ratio = 1.43, 95% CI = 1.24, 1.63) of physician visits compared to low-risk drinkers, adjusting for age and gender. Medium-risk and high-risk drinkers did not differ from low-risk drinkers in terms of out-patient visits. Further regression adjustment for socio-economic covariates, self-reported health status and chronic diseases suggested that abstainers used more out-patient services because they were more ill than drinkers. The effect of mental health status and the number of chronic diseases on out-patient visits was greater for abstainers than drinkers. Conclusions The relation between alcohol consumption and out-patient services is explained partly by poorer health among the abstainers. Further research is needed to affirm these results, such as transferring this evidence to the utilization of in-patient health services. [ABSTRACT FROM AUTHOR]

Background: Objectives of this study are (a) to develop a comprehensive and economic tool to estimate tobacco control (TC) activities in single EU member states, (b) to compare TC activities between member states of the EU. This article provides the questionnaire and gives a benchmark of EU member states according to their perceived TC activities. Methods: An international workshop was specifically initiated to develop the questionnaire "Measuring Activities in Tobacco Control (MATOC)". TC experts from 8 European countries participated and chose 40 items to cover 11 general topics of TC. At the World Conference of Tobacco or Health in Helsinki 2003 participants were asked to fill out the questionnaire. N = 142 participants from EU-member states returned questionnaires. Results: Subjects from the tobacco field in Finland gave the highest TC values to their country, followed by Sweden, Ireland, the UK and the Netherlands. The least active countries in TC were Greece and Germany, behind Austria, Spain, Belgium and Portugal. Italy, France and Denmark constituted the middle field. Conclusion: The MATOC provides a profile of TC across European countries and delivers results that are plausible and fit into the existing findings. The data presented here fulfils the purpose to illustrate what is possible with the MATOC and underlines the value of such an approach in delivering information for policy makers and TC advocates how TC is perceived in each country. Yet, further validity testing is necessary, the number of experts per country differs and is partly rather small. Further research with the MATOC should encounter these limitations. The procedure though could serve as model of practice for alcohol and legal drug policy as well. [ABSTRACT FROM AUTHOR]

Aim: To compare the ages of death caused by tobacco smoking and alcohol risk drinking. Methods: Smoking rates from the largest population survey, alcohol drinking data from the National Health Survey and data from the vital statistics from Germany are used and attributable fractions computed. Results: Alcohol-attributable deaths occurred at the youngest age, followed by tobacco- plus alcohol-attributable cases, whereas death cases attributable to tobacco smoking only occur latest. Conclusion: The overlap in the two substance-use behaviours has to be taken into account when considering attributable mortality data. [ABSTRACT FROM AUTHOR]

Background: Little is known about the clustering of behavioral health risk factors (HRFs), namely the occurrence of 16 specific combinations of tobacco smoking, at-risk alcohol use, overweight and physical inactivity in general hospital patients. Furthermore, social inequalities in HRFs, health and life expectancy are a major concern in public health. In order to establish the need for screening and intervention in general hospital care, the study aimed to determine the co-occurrence of HRFs in patients in four medical departments, and to investigate differences by gender, age and socio-economic characteristics.Methods: Over 17 months, a systematic multiple HRF screening was conducted at one general hospital in northeastern Germany. In total, 6251 18-64 year old patients (92% of eligibles) participated. Proportions and confidence intervals were calculated for all 16 HRF profiles stratified by department, gender, age group, school education, and employment status.Results: In total, 92.2% of the participants (58.6% male) reported ≥1 HRF, and 65.7% ≥2 HRFs. Men (71.2%), patients aged 35-49 (67.9%) and 50-64 years (69.5%), lower educated (79.0%), and unemployed (77.8%) patients had larger proportions of ≥2 HRFs than their counterparts. In all departments, the most common HRF profiles included overweight. HRF profiles that included alcohol and/ or smoking were more common in ear-nose-throat and trauma surgery than in internal medicine and general surgery patients. Men had higher rates concerning almost all HRF profiles including ≥2 HRFs and alcohol; women concerning profiles that included ≤2 HRFs and inactivity. In older patients, profiles with ≥2 HRFs including overweight; and in younger patients, profiles with smoking and/or alcohol were more common. In lower educated patients, profiles with ≥2 HRFs including inactivity; and in higher educated patients profiles with ≤2 HRFs including alcohol were more common. Compared to others, unemployed patients had higher rates of profiles with ≥3 HRFs including smoking.Conclusions: Two in three patients require interventions targeting two or more HRFs. The findings help to develop screening and brief intervention for patients with specific health risk profiles, that can reach most patients, including those most in need and those most hard to reach, with socio-economically disadvantaged people in particular. REGISTRY: clinicaltrials.gov: NCT01291693. [ABSTRACT FROM AUTHOR]

Little is known about the natural course of health-related behaviors such as tobacco smoking, at-risk alcohol use, vegetable and fruit intake and physical activity in general hospital patients after discharge. The aim was to investigate whether patients identified with at-risk alcohol use change their health-related behaviors over two years. Eighteen to 64-year-old patients with at-risk alcohol use were identified through systematic screening as part of a randomized controlled trial. Patients with indication of an alcohol use disorder were excluded. Data of patients who received treatment as usual were analyzed (n = 220). Alcohol use, tobacco smoking, vegetable/ fruit intake, physical activity and body-mass-index were assessed at baseline, after 6, 12, 18, and 24 months. Latent growth models were calculated. Twenty-four months after discharge, participants reported less physical activity (p =.04), a higher body-mass-index (p =.01), no change in vegetable/ fruit intake (p =.11) and smoking status (p =.87), fewer cigarettes per week among smokers (p <.001), and less alcohol use (p <.001) compared to baseline. The data revealed that patients with at-risk alcohol use increased or did not change energy-balance related behaviors and decreased substance-use related behaviors over 2 years after hospitalization. These findings underline the need of implementing multi-behavioral interventions into routine care. [ABSTRACT FROM AUTHOR]

More than 60% of general hospital patients report ≥ 2 health risk behaviors (HRBs), i.e. tobacco smoking, at-risk alcohol use, unhealthy diet, and/or insufficient physical activity. This study investigates a) the association between numbers of HRBs and motivation to change, b) patient preferences for receiving feedback on HRBs, and c) patients' expected gain in quality of life if behavior change made. In 2020/2021, 256 18–64-year-old general hospital patients (72.1% of eligibles) reported on their motivation to change each of their HRBs. Associations between HRB number and motivation were assessed using multivariate linear regressions. Participants ranked HRBs concerning their interest in receiving feedback and concerning their expected gain in quality of life if behavior change occurred. Higher HRB number was negatively related to motivation among at-risk alcohol users (p = 0.034); 24.6% expected gain in their quality of life from behavior change. Participants overall appeared more favorable to feedback about vegetable/fruit intake and physical activity. Unhealthier lifestyle may be accompanied by decreased motivation to change in at-risk alcohol users. In case of co-occurring HRBs, asking patients for expected gain in quality of life may help guiding intervention target. Relying on patient selection only, may often leave substance-use unaddressed. • The more health risk behaviors the lower the motivation to change alcohol use. • Patients (also with low motivation) are open for feedback on health risk behaviors. • Expected gain in quality of life can help focusing multi-behavior interventions. • Relying on patient preference for feedback only may leave substance-use unaddressed. [ABSTRACT FROM AUTHOR]

Objective: to test if people with different day-to-day drinking patterns benefitted differently from two brief alcohol interventions (BAIs).Methods: A total of 1243 job-seekers with at-risk alcohol use aged 18-64 years (64% men) were randomized to (a) intervention tailored to the motivational stage (ST), (b) non-stage tailored intervention (NST), or (c) assessment only (AO). ST and NST contained individualized computer-generated feedback letters. Follow-ups were conducted at months 3, 6, and 15. Using growth mixture models, day-to-day drinking patterns were identified based on the number of drinks consumed on each day in the week prior to baseline assessment. To test drinking pattern-specific intervention effects, zero-inflated growth models were used. Outcomes were (1) the 15-month change in the likelihood of any alcohol use and (2) the 15-month change in the total number of drinks per week when alcohol was consumed.Results: Four day-to-day drinking patterns were found: daily medium use (2-4 drinks/day; 47%), daily low use (1-2 drinks/day; 29%), weekend only use (18%), and no use (6%). Only persons with daily low use benefitted from intervention, with higher odds of being abstinent after 15 months in the ST group compared to AO (odds ratio, OR=1.67, p=0.001) and NST group (OR=1.43, p=0.035). ST worked better among persons with daily low use compared to daily medium use (OR=1.91, p=0.001).Conclusions: Among at-risk drinking persons with regular low-quantity alcohol use, stage tailored BAIs may be superior over no BAI and non-stage tailored BAIs. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate sociodemographic-, living situation- and substance-related variables as predictors of current risky alcohol use for both female and male general hospital inpatients. Method: The sample of 6050 female and 8282 male general hospital inpatients was recruited in 2002–2004. Using the Alcohol Use Disorder Identification Test-Consumption, they were assigned to four drinking groups: abstinent, moderate use, slightly increased use and notably increased use. Gender-specific predictors of group affiliation were determined using multivariate multinomial logistic regressions. Results: In both genders, younger age, rural living environment, the occurrence of lifetime alcohol use disorders (AUDs) and current tobacco smoking were positively associated with risky alcohol use. Higher education was positively associated with slightly and notably increased use for women. Living alone, being divorced/ widowed and being unemployed (relative risk ratios=1.4–1.7) were positively associated with notably increased use for men. In both genders, older age, less education and the occurrence of lifetime AUDs were positively associated with abstinence. Conclusions: Higher educated women are likely to report risky alcohol use. Marriage may have a protective effect on level of alcohol use for men only. In addition to the implementation of routine alcohol screening, the examined data may provide cost-effective information that could be used to tailor interventions. [Copyright &y& Elsevier]

Abstract: Aim: The aims were to investigate differences between alcohol dependent inpatients who seek alcohol treatment and those who do not seek alcohol specific but general hospital treatment, and to investigate problem drinking 12months after hospitalization. Methods: Two samples of alcohol dependent inpatients were recruited: N =571 at general hospitals and N =473 at psychiatric alcohol detoxification units, and were followed-up 12months later. Results: Multivariate logistic regression analyses revealed that higher age, living alone, being employed, previous help-seeking, increased severity of dependence, increased adverse consequences from drinking and increased motivation were significant predictors of receiving alcohol detoxification vs. general hospital treatment. A composite assessment of motivation to change and to seek help was the strongest predictor of positive outcome 12months later. Conclusions: Alcohol dependent individuals who receive detoxification in psychiatric care have a more severe alcohol problem and fewer social resources than those treated in general hospitals. Interventions targeting at enhancing motivation to change and to seek help should be part of routine general hospital care and of detoxification treatment in psychiatric care. [Copyright &y& Elsevier]

Abstract: Aim: To test the effectiveness of a brief alcohol intervention among non-dependent general hospital inpatients with alcohol problems, delivered by either a specialized liaison service or hospital physicians. Method: All inpatients of 29 wards from four general hospitals of one region in Germany were screened for alcohol problems (n =14,332). Of those screening positive, 595 patients were included in a randomized controlled group design using a time-frame. Patients with alcohol dependence were not considered in this study. Patients received Motivational Interviewing based counselling either by a specialized liaison service, by hospital physicians trained under routine conditions or received hospital treatment as usual without additional counselling. One year later, alcohol consumption, motivation and well-being were assessed. Sample survey analyses and generalized estimating equations were conducted. Results: At baseline, the three groups differed regarding motivation, with higher motivation among the controls. At follow-up, the groups did not differ regarding alcohol consumption, alcohol-related problems and well-being. All groups decreased their alcohol consumption significantly. Regarding motivation, longitudinal analyses revealed significant interaction effects of time and intervention (p <0.05), indicating a stronger increase of readiness to change drinking and a less profound drop of readiness to seek help among those who received intervention compared to the controls. Conclusion: The intervention was not effective in reducing alcohol consumption or in increasing well-being 12 months after hospitalization. It had a positive effect on readiness to change drinking and on readiness to seek formal help for alcohol problems. The intervention groups compensated their lag of motivation. [Copyright &y& Elsevier]

Abstract: Background: Studies investigating factors of treatment entry have predominantly focussed on persons that have already taken an initial step in the process of help-seeking. With particular emphasis on intention to utilize help, this study aims to detect predictors for alcohol-related help-seeking among a non-help-utilizing sample. Methods: Using 312 individuals with diverse alcohol problems (dependence, abuse, at-risk drinking), intention to utilize help was assessed in addition to evidence based predictors for utilization of help (e.g. severity of alcohol problem, prior help-seeking). Results: In addition to prior utilization of help (OR=9.76, CI: 4.60–20.74) and adverse consequences from drinking (OR=1.13, CI: 1.02–1.25), intention to utilize help (OR=4.84, CI: 2.04–11.51) was a central predictor for help-seeking. Among individuals who had not obtained prior help, individuals intending to seek help were 8.7 times more likely to utilize help than those not intending to seek help (CI: 1.05–72.2). Conclusions: In the past, intention to utilize help has been neglected from models investigating treatment entry. This study''s findings show that intention is a central factor for utilization of alcohol-specific formal help. Consequently, brief interventions focusing on enhancing motivation are expected to improve early help-seeking among general hospital patients with diverse alcohol problems. [Copyright &y& Elsevier]

Little is known about the long-term impact of brief alcohol interventions (BAIs) on health and on sick days in particular. The aim was to investigate whether BAIs reduce sick days in general hospital patients over two years, and whether effects depend on how BAIs are delivered; either through in-person counseling (PE) or computer-generated written feedback (CO). To investigate this, secondary outcome data from a three-arm randomized controlled trial with 6-, 12-, 18- and 24-month follow-ups were used. The sample included 960 patients (18-64 years) with at-risk alcohol use identified through systematic screening on 13 hospital wards. Patients with particularly severe alcohol problems were excluded. Participants were allocated to PE, CO and assessment only (AO). Both interventions were tailored according to behavior change theory and included three contacts. Self-reported number of sick days in the past 6 months was assessed at all time-points. A zero-inflated negative binomial latent growth model adjusted for socio-demographics, substance use related variables and medical department was calculated. In comparison to AO, PE (OR = 2.18, p = 0.047) and CO (OR = 2.08, p = 0.047) resulted in statistically significant increased odds of reporting no sick days 24 months later. Differences between PE and CO, and concerning sick days when any reported, were non-significant. This study provides evidence for the long-term efficacy of BAIs concerning health, and concerning sick days in particular. BAIs have the potential to reduce the occurrence of sick days over 2 years, independent of whether they are delivered through in-person counseling or computer-generated written feedback. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]