Cited by 3,005Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsPsychological Testing and Assessment

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Detecting Alcoholism: The CAGE Questionnaire

Ewing, John A.·1984·JAMA

DOI 10.1001/jama.1984.03350140051025

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Abstract

Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The acronym "CAGE" helps the physician to recall the questions. How these questions were identified and their use in clinical and research studies are described. (JAMA1984;252:1905-1907)

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Crossref · 10.1001/jama.1984.03350140051025

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BackgroundMethod
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Wagner, J. A., Armeli, S., Tennen, H. A., Bermúdez‐Millán, A., Wolpert, H. A., & Pérez‐Escamilla, R. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000477 · Cited by 32
A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health
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Sedentary Behaviour and 12 Sleep Problem Indicators among Middle-Aged and Elderly Adults in South Africa
Pengpid, S., & Peltzer, K. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16081422 · Cited by 33
Adverse Childhood Experiences and Adolescent Exposure to Violence
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“At age 4, caregivers rated their problematic alcohol use according to four binary (no/yes) items (e.g., “have you ever felt you should cut down on your drinking?”) from the four-question “CAGE” questionnaire (Ewing, 1984).”
Method
The risk of pregnancy‐associated hypertension in women with nonalcoholic fatty liver disease
Jung, Y. M., Lee, S. M., Hong, S., Koo, J. N., Oh, I. H., Kim, B. J., Kim, S. M., Kim, S. Y., Kim, G. M., Joo, S. K., et al. (2020) · Liver International · doi:10.1111/liv.14563 · Cited by 35
Dysregulated brain salience within a triple network model in high trait anxiety individuals: A pilot EEG functional connectivity study
Massullo, C., Carbone, G. A., Farina, B., Panno, A., Capriotti, C., Giacchini, M., Machado, S. E. D. C., Budde, H., Murillo‐Rodríguez, E., & Imperatori, C. (2020) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2020.09.002 · Cited by 29
Recognition and Treatment of Late-Life Addictions in Medical Settings
Stewart, D., & Oslin, D. W. (2001) · Journal of Clinical Geropsychology · doi:10.1023/a:1009589706810 · Cited by 34
“The CAGE questionnaire ( Ewing, 1984 ), a 4-item screen administered in oral or written form, can effectively discriminate individuals with a history of alcohol dependence from those without such a history.”
Method
Identifying and managing acute alcohol withdrawal in the elderly
Letizia, M., & Reinbolz, M. (2005) · Geriatric Nursing · doi:10.1016/j.gerinurse.2005.03.018 · Cited by 34
Substance Abuse and the Emergency Room
el‐Guebaly, N., Armstrong, S. J., & Hodgins, D. C. (1998) · Journal of Addictive Diseases · doi:10.1300/j069v17n02_03 · Cited by 32
Impact of an Alcohol Withdrawal Syndrome Practice Guideline on Surgical Patient Outcomes
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Ideación suicida en estudiantes de medicina: prevalencia y factores asociados
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Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence
Tommasello, A. C. (2004) · Harm Reduction Journal · doi:10.1186/1477-7517-1-3 · Cited by 33
“However, a single "yes" response is considered a positive screen and should trigger a referral to a substance abuse specialist for a full assessment [25].”
Background
Developmental Trajectories of Behavior Problems Among Children Who Have Experienced Maltreatment
Tabone, J. K., Guterman, N. B., Litrownik, A. J., Dubowitz, H., Isbell, P., English, D. J., Runyan, D. K., & Thompson, R. (2010) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426610383861 · Cited by 34
“Caregiver alcohol problems were assessed by the CAGE Questionnaire (Ewing, 1984).”
Method
A prospective study of neuropsychological functioning in testicular cancer patients
Skaali, T., Fosså, S. D., Andersson, S., Cvancarova, M., Langberg, C. W., Lehne, G., & Dahl, A. A. (2010) · Annals of Oncology · doi:10.1093/annonc/mdq553 · Cited by 34
“Alcohol use at baseline was assessed with a 4-item version of the ‘CAGE questionnaire’ [28], with sum scores ranging from 0 (low) to 4 (high).”
Method
Determinants of Target Organ Damage in Black Hypertensive Patients Attending Primary Health Care Services in Cape Town: The Hi-Hi Study
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Treating the Sexually Addicted Client: Establishing a Need for Increased Counselor Awareness
Hagedorn, W. B., & Juhnke, G. A. (2005) · Journal of Addictions & Offender Counseling · doi:10.1002/j.2161-1874.2005.tb00194.x · Cited by 34
“Similar to the success of the CAGE clinical interview that was developed by Ewing and Rouse in 1970 (Ewing, 1984) to assess for the presence of alcoholism, the acronym WASTE Time was created for working with clients presenting with sexual addiction.”
Method
Gender differences in the contributions of risk factors to depressive symptoms among the elderly persons dwelling in a community, Japan
Katsumata, Y., Arai, A., Ishida, K., Tomimori, M., Denda, K., & Tamashiro, H. (2005) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1403 · Cited by 34
“Alcohol dependence was detected by the CAGE questionnaire consisting of four items (Ewing, 1984), on which the responses were scored 0 or 1 and the total score of 2 or more was considered Copyright # 2005 John Wiley & Sons, Ltd. Int J Geriatr Psychiatry 2005; 20: 1084–1089. clinically significant.”
Method
COMPARISON OF CYANAMIDE AND PLACEBO IN THE TREATMENT OF ALCOHOL DEPENDENCE OF ADOLESCENTS
Niederhofer, H., Staffen, W., & Mair, A. (2003) · Alcohol and Alcoholism · doi:10.1093/alcalc/agg011 · Cited by 34
A COMPARISON OF DRINKING PATTERNS AND ALCOHOL-USE- RELATED PROBLEMS IN THE UNITED STATES AND GERMANY, 1995
Bloomfield, K., Greenfield, T. K., Kraus, L., et al. (2002) · Substance Use & Misuse · doi:10.1081/ja-120002803 · Cited by 34
“The CAGE questionnaire was developed to screen for alcoholism or covert drinking problems in clinical populations (35), not for conclusive diagnosis of alcoholism or alcohol dependence.”
Method
Psychological Aspects of Care in Cancer Patients in the Last Weeks/Days of Life
Ann‐Yi, S., & Bruera, E. D. (2022) · Cancer Research and Treatment · doi:10.4143/crt.2022.116 · Cited by 38
Energy-drink consumption and its relationship with substance use and sensation seeking among 10th grade students in Istanbul
Evren, C., & Evren, B. (2015) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2015.05.001 · Cited by 33
Risk factors for relapse to problem drinking among current and former US military personnel: A prospective study of the Millennium Cohort
Williams, E. C., Frasco, M. A., Jacobson, I. G., Maynard, C. C., Littman, A. J., Seelig, A. D., Crum‐Cianflone, N. F., Nagel, A. C., & Boyko, E. J. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.12.031 · Cited by 34
“Problem drinking Baseline problem drinking was assessed using the lifetime version of the CAGE questionnaire (Ewing, 1984; Have you ever felt the need to cut down your drinking, felt annoyed by criticism of your drinking, had guilty feelings about drinking, taken a morning eye opener?) and the…”
BackgroundMethod

Authors: Ewing, J. A.
Corresponding author: Ewing, John A.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 1984-10-12
Volume: 252
Issue: 14
Pages: 1905
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1984.03350140051025
OpenAlex: W4254121089
Cited by: 3,005
References: 0
Citations by year: 2026: 40 · 2025: 79 · 2024: 67 · 2023: 80 · 2022: 103 · 2021: 103 · 2020: 186 · 2019: 114 · 2018: 128 · 2017: 130 · 2016: 136 · 2015: 142 · 2014: 144 · 2013: 137 · 2012: 133
FWCI: 5.09
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: alcoholism, CAGE questionnaire, screening questions, clinical interview, diagnostic criteria

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Detecting Alcoholism: The CAGE Questionnaire

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