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Detecting Alcoholism: The CAGE Questionnaire
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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“Για την ποσοτική αξιολόγηση της τρέχουσας καταθλιπτικής και αγχώδους συμπτωματολογίας, καθώς και της προβληματικής κατανάλωσης αλκοόλ, χρησιμοποιήθηκαν, αντίστοιχα, οι κλίμακες Patient Health Questionnaire (PHQ-9 27,28 ), Beck Anxiety Inventory (BAI 29,30 ) και CAGE. 31,32”
From Clinical presentation and requests for support of people with HIV/AIDS seeking counselling and psychotherapy in Greece (2019) · cites this paper as [31]
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“, questions about cutting down on drinking, annoyance at others' concern about drinking, feeling guilty about drinking, and using alcohol as an eye opener in themorning) for the partners [15].”
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“The CAGE questionnaire was originally developed by Ewing and Rouse in 1968 [10], and was designed to detect current alcoholics.”
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“The baseline severity of the patients was measured following various scales: cut-annoyed, guilty-eye opener (CAGE) Questionnaire (Ewing, 1984), DSM-IV diagnostic criteria for alcohol dependence disorders, two four-category investigator-filled questionnaires of alcohol psychological dependence (no desire, mild, moderat…”
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“Alcohol misuse was extracted from a set of four questions comprising the CAGE (Ewing, 1984) questionnaire: ‘‘Have you ever felt you needed to Cut down on your drinking?”
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“Drinking is measured with the Cut, Annoyed, Guilty, Eye Opener (CAGE) questionnaire to indicate heavy drinking and drinking problems (Ewing 1984).”
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“One substance abuse-specific instrument, which is short, simple and easily-learned, the CAGE, would be ideal for this purpose (Ewing, 1984).”
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“2000) to screen for previous mood elevation and symptoms of bipolar disorder, CAGE alcohol screen (Ewing 1984), and the 10-item Drug Abuse Screening Test (DAST) (Skinner 1982).”
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“Screening for alcohol abuse Alcohol abuse was diagnosed using the CAGE (Cutting down, Annoyance by criticism, Guilty feelings, Eyeopeners) questionnaire [19].”
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“Problem alcohol use was assessed using the CAGE Alcohol Abuse Screening Measure (CAGE; Ewing, 1984).”
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“For instance, several providers reported familiarity with and use of the CAGE questionnaire (Ewing, 1984), which assesses consequences related to drinking, to assess alcohol use; others reported assessing symptom severity and drinking context.”
BackgroundWhittamore, K. H., Goldberg, S. E., Gladman, J. R. F., et al. (2013) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3961 · Cited by 61
“These comprised the abbreviated mental test score (Hodkinson, 1972), four-item Geriatric Depression Scale (Shah et al., 1997), CAGE alcoholism questions (Ewing, 1984) and a question to identify patients with a prior psychiatric diagnosis or behaviours suggesting a mental health problem.”
Welch, G. W., Wesolowski, C., Zagarins, S., Kuhn, J. N., Romanelli, J. R., Garb, J., & Allen, N. A. (2010) · Obesity Surgery · doi:10.1007/s11695-009-0069-3 · Cited by 61
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“The 1-year prevalence for an alcohol-use disorder in women is 2.6%, as compared to 11.0% for men, and the rate of alcohol dependence, as measured by the CAGE questionnaire (answered “yes” for two or more questions; see Ewing, 1984), is 10.5% for women and 26.1% for men over age 20 (MOHW).”
InfluentialWomen and Addiction: An Update
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“Higher scores are indicative of alcohol problems and a total score of 2 or more is generally considered clinically significant and warrants further assessment.(56) In this study the calculated Cronbach’s a for the 4-item CAGE scale was 0.”
BackgroundSprince, N. L., Park, H., Zwerling, C., et al. (2003) · The Journal of Rural Health · doi:10.1111/j.1748-0361.2003.tb00558.x · Cited by 60
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Multicenter Study of Case Finding in Elderly Emergency Department Patients
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Catch, Treat, and Release: Veteran Treatment Courts Address the Challenges of Returning Home
Slattery, M., Dugger, M., Lamb, T. A., & Williams, L. (2013) · Substance Use & Misuse · doi:10.3109/10826084.2013.797468 · Cited by 65
“The Cut down, Annoyed, Guilty, Eye-Opener instrument is widely used in criminal justice as a quick, easy to remember screen for alcohol dependence or misuse (Ewing, 1984).”
MethodSystematic Review of the Michigan Alcoholism Screening Test
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“The primary outcomes measured were the K6 Psychological Distress Scale,(28) a shortened version of the Pittsburgh Sleep Index,(29) and the CAGE Questionnaire for substance abuse.(30,31) Scores on the K6 ranged from zero to 24, where scores of 12 and below indicate low to moderate distress and 13 or higher indicate sev…”
MethodKing, M., & Nazareth, I. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-127 · Cited by 58
“The four-item CAGE questionnaire [25], which is a known screening instrument for possible alcohol misuse.”
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Griffiths, C., Guest, E., White, P., Gaskin, E., Rumsey, N., Pleat, J., & Harcourt, D. M. (2016) · Journal of Burn Care & Research · doi:10.1097/bcr.0000000000000474 · Cited by 60
Pitpitan, E. V., Kalichman, S. C., Eaton, L. A., Cain, D. N., Sikkema, K. J., Watt, M. H., Skinner, D. G., & Pieterse, D. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-012-9420-3 · Cited by 58
Murphy, C., Kearney, P. M., Shelley, E., Fahey, T. P., Dooley, C., & Kenny, R. A. (2015) · Journal of Public Health · doi:10.1093/pubmed/fdv057 · Cited by 60
Unrecognized suicidal ideation in ED patients: are we missing an opportunity?
Kemball, R. S., Gasgarth, R., Johnson, B., Patil, M., & Houry, D. (2008) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2007.09.006 · Cited by 62
“To assess alcohol abuse the CAGE screener for alcoholism was used [14].”
MethodBiello, K. B., Oldenburg, C. E., Safren, S. A., Rosenberger, J. G., Novak, D. S., Mayer, K. H., & Mimiaga, M. J. (2016) · AIDS Care · doi:10.1080/09540121.2016.1146205 · Cited by 58
McKenna, H., Treanor, C., O’Reilly, D., & Donnelly, M. (2018) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-018-0143-8 · Cited by 55
“(Cut down, Annoyed, Guilty, Eye-opener) [45]) and a quantity-frequency measure when research assistants”
BackgroundMethodInfluentialHarpur, L. J., Polek, E., & van Harmelen, A. (2015) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2015.05.019 · Cited by 57
Communication Skills for Preventive Interventions
Dube, C. E., O’Donnell, J. F., & Novack, D. H. (2000) · Academic Medicine · doi:10.1097/00001888-200007001-00007 · Cited by 59
Alcohol abuse and dependence in elderly emergency department patients
Onen, S. ‐., Onen, F., Mangeon, J.-P., Abidi, H., Courpron, P., & Schmidt, J. (2005) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2005.02.002 · Cited by 58
Ao, T. T.-H., Sam, N. E., Masenga, E. J., Seage, G. R., & Kapiga, S. (2006) · Sexually Transmitted Diseases · doi:10.1097/01.olq.0000187204.57006.b3 · Cited by 58
Evaluation and Management of Geriatric Depression in Primary Care
Lapid, M. I., & Rummans, T. A. (2003) · Mayo Clinic Proceedings · doi:10.4065/78.11.1423 · Cited by 58
A Study of Mild Dementia in the Community Using a Wide Range of Diagnostic Criteria
Mowry, B. J., & Burvill, P. W. (1988) · The British Journal of Psychiatry · doi:10.1192/bjp.153.3.328 · Cited by 59
“Where appropriate, other psychiatric diagnoses were made according to DSM—IIIcriteria, alcoholism was diagnosed according to the CAGE Questionnaire (Ewing, 1984) and pervasive depression according to Gurland et al(l983).”
MethodMiller, K. A., Piombo, S. E., Cho, J., Higgins, S., Wysong, A. S., Sussman, S. Y., Cockburn, M., & Leventhal, A. M. (2018) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2018.02.018 · Cited by 58
“Tanning addiction was measured by the mCAGE measure, a tanning-modified version of the CAGE measure, a validated scale for assessing problem drinking and alcohol abuse (Ewing, 1984; Warthan et al., 2005).”
MethodSuccessful Development: Childhood Antecedents of Adaptive Psychosocial Functioning in Adulthood
Pulkkinen, L., Nygren, H., & Kokko, K. (2002) · Journal of Adult Development · doi:10.1023/a:1020234926608 · Cited by 57
“Controlled drinking was assessed by two alcoholism screening tests, a modification of the Michigan Alcoholism Screening Test (Selzer, 1971) and the CAGE Questionnaire ( Ewing, 1984 ), and by questions about the annual use of alcohol, frequency of intoxication, and problems arising from drinking.”
Method
Metadata
- 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
- 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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