Fast Five Quiz: How Much Do You Know About Alcoholism?

Stephen Soreff, MD

Disclosures

January 26, 2017

Patients commonly use a psychiatric disorder to deny alcohol abuse. This underscores the high rate of alcohol users with denial of the problem.

Unless strong evidence indicates that the psychiatric disorder clearly precedes the alcoholism or is present during a long period of sobriety, the best plan is to proceed as if alcoholism is the primary diagnosis. Arrange a consultation with a psychiatrist for difficult cases because some patients who are treated for psychiatric conditions stop drinking and do very well.

The following are signs of chronic alcoholism:

  • Gynecomastia

  • Spider angiomata

  • Dupuytren contractures (also may be congenital)

  • Testicular atrophy

  • Enlarged or shrunken liver

  • Enlarged spleen

  • Anemia

  • Cardiovascular disease

  • Cancer

  • Gout

  • Seizures

  • Hypertension

  • Neuropathy

  • Serious infections

CAGE is a questionnaire that is less reliable when given after asking questions on frequency. The CAGE questions are not useful for diagnosing hazardous drinking. The CAGE questionnaire also may fail to identify binge drinkers and cannot identify those who have not experienced the consequences of alcoholism. By itself, the CAGE questionnaire is not an adequate screening for alcohol problems, although it may indicate the existence of an alcohol problem.

Family history commonly reveals members with bipolar disorder, schizophrenia, and/or alcoholism.

For more on the presentation of alcoholism, read here.

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