The efficiency of a questionnaire in detecting heavy drinkers

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Abstract
The suitability of the nine‐question Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) was tested on 133 40‐year‐old men and 140 45‐year‐old men attending a voluntary population health screening in a typically week‐end‐drinking society. With a cut‐off level of two yes' answers 29% of the middle‐aged male population has been reported to give a positive result in this questionnaire. In our study alcoholics were excluded. The amount and type of alcohol consumed per week was asked. The subjects were divided into three groups: (1) social drinkers (0 or 1 yes' answer), (2) suspect abusers (two “yes” answers), and (3) abusers (three or more yes' answers or drinking at least 280 g absolute alcohol per week). Group 2 reported drinking more than group I, but according to biological markers they belonged better to group 1 than group 3. With the originally recommended cut‐off level of two yes'answers 50.8% of 40‐year‐old men and 36.5% of 45‐year‐old men in our study proved positive. With the three yes’answer criterion the corresponding percentages were 28.5 and 24.0. Forty‐ and 45‐year‐old men in group 2 gave many positive answers in the question concerning week‐end drinking and avoidance of alcohol for a time, as did 40‐year‐old men in the question concerning bad conscience after drinking. Beer and spirits were the most popular beverage combination and week‐end drinking was the commonest drinking habit. The number of positive answers correlated well with the announced amount of alcohol. In Mm‐MAST typical week–end drinking is linked with many positive answers although the weekly amount of alcohol remains low. In many cases the questionnaire was the only way to diagnose alcohol abuse. It should be kept in mind that the specificity of questionnaires is not equal in different cultures. Concerning the Mm‐MAST questionnaire we recommend three yes’answers as a cut‐off level in week‐end‐drinking societies.