UTILITY OF THE SELF-ADMINISTERED ALCOHOLISM SCREENING-TEST (SAAST) IN SCHIZOPHRENIC-PATIENTS

The utility of the Self‐Administered Alcoholism Screening Test (SAAST) in determining alcohol abuse and alcoholism was assessed in a preliminary study of 21 schizophrenic patients during their hospitalization in an acute care psychiatric unit; on admission all met DSM‐III‐R criteria for schizophrenia and none were detected to have any alcohol‐related diagnosis. SAAST scores ranged from 2 to 26 with a mean score of 10.8. Forty‐eight percent (10/21) had SAAST scores greater than or equal to 10, indicating “probable alcoholism”; 62% (13/21) scored 8 or higher. Every patient with a SAAST score of 8 or higher also met DSM‐III‐R criteria for alcohol abuse or dependence on the basis of patient interview, independent chart reviews, and interviews of significant others. In contrast, only half (5/10) of the high SAAST scorers would actually admit to a problem with drinking during the extensive study interviews. Six SAAST items were found to be highly predictive of abuse or alcoholism; the SAAST had greater sensitivity than the interviews. Sixty‐two percent (8 of 13) of the schizophrenic patients who met the DSM‐III‐R criteria for alcohol abuse reported a first degree relative with an alcohol‐related problem, in contrast to only 25% of the “nonalcoholic” patients. The patterns of the alcoholic schizophrenic patients' responses on the different SAAST items revealed even greater denial and lack of insight than those of nonschizophrenic alcoholic subjects. Copyright © 1990, Wiley Blackwell. All rights reserved