Clinicians can improve their ability to estimate a patient's risk for an alcohol abuse or dependence disorder using likelihood ratios for CAGE scores.

Our physicians appear to rely on specific patient characteristics as well as the patient's medical record to detect drinking problems in their ambulatory patients. Their reliance upon these factors may hinder their detection of drinking problems in women patients and less seriously impaired individuals.

Providing physicians with the results of the Diagnostic Interview Schedule and counseling directives resulted in short-term improvement in their rates of counseling patients with a history of dependent or nondependent but harmful drinking. Further research is necessary to determine long-term gains in rates of physician counseling and improvements in the course of these patients.

Over a one-year period the authors administered the Diagnostic Interview Schedule to 459 randomly selected patients attending an urban general medicine practice. Alcohol abuse and alcohol dependence disorders were diagnosed as current in 12% of the patients, while 19% of the patients met criteria for a past disorder. In addition, 11% and 3%, respectively, reported a history of previous or current heavy consumption. The lifetime prevalence of alcohol consumption disorders is significantly higher in males than females, while current disorders are significantly more common in younger than older individuals. Based upon the number of reported symptoms, patients reporting current disorders appear to have a more serious form of disease than patients reporting a past disorder. We conclude that disorders of alcohol consumption are common in our medical practice. Moreover, our findings suggest that many patients do recover from alcohol consumption disorders (i.e. are currently symptom-free by self-report) and disease severity may be an important factor in this process.

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