The AUDIT-C: screening for alcohol use disorders and risk drinking in the presence of other psychiatric disorders☆

Abstract 

This article examines the performance of the AUDIT-C, as embedded in a large national survey, as a screener for alcohol use disorders (AUDs) and risk drinking among individuals with past-year psychopathology. The analysis is based on data collected in personal interviews from a representative population sample of US adults. The study population consisted of past-year drinkers with any past-year mood disorder (n = 2818), any past-year anxiety disorder (n = 3173), or any personality disorder (n = 4389). Screening performance was evaluated by means of sensitivity, specificity, and areas under receiver operating characteristic curves (AUCs). The AUCs for the AUDIT-C were from 0.888 to 0.893 for alcohol dependence, from 0.864 to 0.876 for any AUD, and from 0.941 to 0.951 for any AUD or risk drinking—all on a par with those observed in the general population. Among men, cut points of either ≥5 or ≥6 points (the former favoring sensitivity and the latter favoring specificity) were optimal for detecting dependence, and cut points of ≥5 points were optimal for any AUD and for any AUD or risk drinking. Among women, a cut point of ≥4 points was optimal for the outcomes of both alcohol dependence and any AUD, whereas a cut point of ≥3 points was preferable for detecting any AUD or risk drinking.