폭음에 대한 한 가지 질문을 통한 문제 음주자 선별의 유용성 검토
Utility of Single Alcohol Questions Related to Binge Drinking in Identifying Problem Drinkers
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연구배경: 본 연구는 폭음관련 한 가지 질문을 통해서 문제 음주자 선별에의 유용성을 알아보고자 하였다. 방법: 261명의 남녀를 대상으로 하여 가정의가 면담을 통하 여 문제음주 여부를 확인하였다. 문제음주는 위험음주 또는 알코올 사용장애로 정의하였고 National Alcohol Institute on Alcoholism and Alcohol Abuse 가이드라인과 DSM-IV TR을 기 준으로 하였다. 폭음관련 질문에 대한 3가지 예로 “지난 3개월 이내에 가장 많이 술을 마신 양은 얼마입니까?”, “지난 3개월 동안 하루에 1.5병(여자-1병) 이상 마신 적이 몇 번이나 있습 니까?”, “보통 1주일에 몇 번이나 술에 취하세요?”라는 질문을 하였다. 문제음주여부에 대한 면담 결과를 기준으로 폭음관 련 질문들의 문제 음주자 선별에의 유용성을 평가하였다. 결과: 261명의 대상자 중에 31.4%가 위험 음주자, 30.2%는 알 코올사용장애, 36.8%는 문제 음주자였다. 첫 번째 질문의 기준 점을 4잔(여자-3잔)으로 하였을 때 남자에 있어서 민감도가 93.8%, 특이도가 75.0%였고 여자는 각각 86.6%, 86.7%였다. 두 번째 질문의 기준점을 남녀 모두 1회로 하였을 때 남자는 민 감도와 특이도가 각각 81.3%, 86.5%였고 여자는 80.0%, 89.4% 였다. 세 번째 질문의 기준점을 0.25회로 하였을 때 남자는 민 감도와 특이도가 61.7%, 92.3%였고, 여자는 46.7%, 91.2%였다. Receiver Operating Characteristic 곡선 아래 면적은 첫 번째 질문 이 남녀 각각 0.937, 0.970였고, 두 번째 질문이 각각 0.906, 0.915 였으며, 세 번째 질문은 각각 0.768, 0.764였다. 결론: 폭음에 대한 3가지 질문 중 첫 번째 질문(3개월 내 최대 음주량) 또는 두 번째 질문(3개월 내 폭음 횟수)이 문제 음주 자 선별에 유용할 것으로 생각한다.
Abstract
Background: This study was done to validate the three single questions about binge drinking for identifying problem drinkers. Methods: Two hundred sixty-one patients (133 men) were interviewed by family physicians for the presence of problem drinking which was defi ned as at-risk drinking or alcohol use disorders according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guideline and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The three single questions (the largest amount of drinking in a day; days of drinking 1.5 bottle [1 bottle in women] or more of Soju [Korean alcoholic beverage, 56 g of alcohol/bottle]; and days of getting drunk during the recent 3 months) were validated against the interview results. Results: Among 261 interviewees, 31.4% were at-risk drinkers, 30.2% had a current alcohol use disorder, and 36.8% had either or both conditions. The fi rst question, considering 4 drinks or more for men and 3 drinks or more for women as positive, showed a sensitivity of 93.8% and specificity of 75.0% in men, and 86.6% and 86.7% in women, respectively. The second question with cut-point of 1 in both gender showed 81.3% and 86.5% in men, respectively and 80.0% and 89.4%, respectively in women. The third question with cut-point of 3 in both gender showed 61.7% and 92.3% in men, respectively and 46.7% and 91.2%, respectively in women. The area under the Receiver Operating Characteristic curve of the fi rst question was 0.937 in men and 0.970 in women, for the second question, 0.906 and 0.915, and for the third question, 0.768 and 0.764, respectively. Conclusions: The first question (the largest amount of drinking in a day during the recent 3 months) and the second question (days of drinking 1.5 bottle [1 bottle in women] or more of Soju during the recent 3 months) were considered useful in detecting problem drinkers.
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