Brazilian Journal of Psychiatry (Sep 2004)

Avaliação de instrumento de detecção de problemas relacionados ao uso do álcool (CAGE) entre trabalhadores da prefeitura do campus da Universidade de São Paulo (USP) - campus capital Evaluation of a screening test for alcohol-related problems (CAGE) among employees of the Campus of the University of São Paulo

  • Ricardo Abrantes do Amaral,
  • André Malbergier

DOI
https://doi.org/10.1590/S1516-44462004000300005
Journal volume & issue
Vol. 26, no. 3
pp. 156 – 163

Abstract

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O uso do álcool pode ser responsável por acidentes, atrasos e faltas no trabalho. Sua detecção é limitada pelas dificuldades de pacientes e médicos quanto ao assunto. O questionário CAGE pode ser uma alternativa fácil, rápida e pouco intimidativa na detecção dos problemas relacionados ao uso de álcool (PRA). OBJETIVOS: Avaliar os indicadores de validade do CAGE - sensibilidade (S), especificidade (E), valor preditivo positivo, VPP e a área sob a curva ROC, ASC - entre funcionários da Prefeitura da Cidade Universitária, utilizando a Entrevista Clínica Estruturada para o DSM-IV, a SCID 2.0. MÉTODOS: Foram selecionados aleatoriamente 203 funcionários para entrevista com um questionário sociodemográfico seguido do CAGE e da SCID 2.0 Os indicadores de validade do CAGE foram analisados através dos resultados da SCID 2.0 para abuso e dependência do álcool e os dados sociodemográficos pelo cálculo do qui-quadrado. RESULTADOS: Entre os 192 funcionários entrevistados, a prevalência do CAGE positivo foi 19,8%, com os seguintes indicadores de validade para a detecção de PRA: S=84,4%, E=93,1%, VPP=71,1% e ASC=0,88 (pAlcohol intake may play a significant role in absenteeism, delays and accidents at the workplace. However, its detection is limited by difficulties of both patients and physicians regarding the subject. The CAGE questionnaire may be an easy, fast and non intimidative alternative to detect alcohol-related problems (ARP). OBJECTIVES: To evaluate the validity coefficients of the CAGE (sensitivity, Sen; specificity, Spec; positive predictive value, PPV, and the area under the ROC curve - AUC) among employees of the Campus of the University of São Paulo using the Structured Clinical Interview for DSM-IV, SCID 2.0. METHODS: A random 203-worker sample was selected to be surveyed with a socio-demographic questionnaire followed by the CAGE questions and the SCID 2.0. CAGE validity coefficients were analyzed according to the SCID 2.0 results for alcohol abuse and dependence, while sociodemographic data were analyzed by the chi-square test. RESULTS: Among 192 interviewed workers, the prevalence of the CAGE-positive was 19,8%. Validity coefficients results were for ARP: Sen=84,4%, Spec=93,1%, PPV=71,1% and AUC=0,88 (p<0,01); and for alcohol dependence: Sen=91,3%, Spec=89,9%, PPV=55,3% and AUC=0,90 (p<0,01). There were significant associations between CAGE-positive and the following characteristics: 1) age (61 years or more, p=0,04), 2) male gender (p=0,01) and 3) blue color occupations (p=0,02). CONCLUSION: The PPV of the CAGE suggested its better performance in screening ARP (abuse and dependence) than only alcohol dependence. The association with age and sex could be related to limitations of the questionnaire. Blue color occupations could indicate a risk factor for ARP. The CAGE was considered valid for the screening of ARP at the workplace.

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