10-item screen for alcohol use disorder has 'value' for clinical and genetic studies

A 10-item screen for alcohol use disorder appeared valuable for clinical and genetic studies related to the disorder, according to results of a genome-wide association study published in American Journal of Psychiatry.

Researchers used the Alcohol Use Disorders Identification Test (AUDIT) as the screen.

“In the present study, we sought to elucidate the genetics of alcohol consumption and problematic consequences of alcohol use measured via AUDIT using genomic structural equation modeling, a novel multivariate framework that allows structural equation modeling techniques to be applied to genetic covariance matrices based on GWAS results,” Travis T. Mallard, MA, of the department of psychology at the University of Texas at Austin, and colleagues wrote. “Accordingly, we undertook the first item-level and the largest-to-date [genome-wide association study (GWAS)] meta-analyses of AUDIT (N = 160,824), using data from three population-based cohorts of European ancestry. We then used genomic structural equation modeling to analyze the item-level GWAS results with the aims of 1) investigating the latent genetic factor structure of AUDIT, based on prior knowledge, and 2) conducting multivariate GWASs of the resulting latent genetic factor(s).”

The researchers mitigated biases in prior studies by applying the multivariate framework. Findings demonstrated that the AUDIT items had novel patterns of similarity and dissimilarity. The researchers noted evidence of a correlated two-factor structure at the genetic level, which existed between “consumption” and “problems.” They created an aggregate alcohol consumption measure by applying empirically derived weights to each of the AUDIT items and found that it was strongly linked to alcohol dependence, moderately linked to several other psychiatric disorders and no longer positively linked to health and positive socioeconomic outcomes. Further, they pinpointed novel genetic associations between alcohol consumption, alcohol misuse and health by conducting polygenic analyses in three independent cohorts that had different ascertainment and prevalence of alcohol use disorder.

“The consumption factor was a good genetic proxy of [alcohol use disorder] when appropriate weights were applied to the individual items using genomic structural equation modeling,” Mallard and colleagues wrote. “This is a striking change from previous investigations into the divergent genetic bases of alcohol consumption and problematic use, including our own prior analyses of AUDIT.”