CAGE questionnaire

Alcohol dependence is likely if the patient gives 2 or more positive answers:

• have you ever felt you should CUT down your drinking?
• have people ANNOYED you by criticising your drinking?
• have you ever felt bad or GUILTY about your drinking?
• have you ever had a drink first think in the morning to steady your nerves or get rid of a hangover (EYE- opener)? (1)

A score of 2 to 3 indicates a high index of suspicion and a score of 4 is virtually diagnostic for alcoholism (2).

• Bernadt et al have claimed that the CAGE test (scores >=2) has a sensitivity of 93% and a specificity of 76% for the identification of problem drinkers
• the sensitivity of the CAGE questionnaire in screening for alcoholism is dramatically enhanced by an open-ended introduction (3)

The CAGE shares the disadvantage of the MAST that it asks about the respondent’s lifetime experience of alcohol rather than focusing on the recent past (1)

Reference:

• (1) The National Treatment Agency for Substance Misuse (NTA) 2006. Review of the Effectiveness of Treatment for Alcohol Problems
• (2) O'Brien CP. The CAGE questionnaire for detection of alcoholism: a remarkably useful but simple tool. JAMA. 2008;300(17):2054-6.
• (3) Bernadt et al (1982). Comparison of questionnaire and laboratory tests in detection of excessive drinking and alcoholism. Lancet, 1, 325-8.
• (4) Steinweg DL, Worth H.Alcoholism: the keys to the CAGE. Am J Med. 1993;94(5):520-3