Evaluation of a Clinical Screening Instrument to Identify States of Thiamine Deficiency in Inpatients With Severe Alcohol Dependence Syndrome

AIMS: To develop a Thiamine Deficiency Questionnaire (TDQ), and to assess its reliability in the identification of Thiamine deficiency, in patients with severe alcohol dependence. METHODS: 58 severely alcohol dependent patients underwent socio-demographic, medical, psychiatric, and alcohol use assessment, including administration of the Thiamine Deficiency Questionnaire (TDQ). The Red Blood Cell Thiamine Pyrophosphate concentration provided the 'gold standard' to test the validity of the instrument. Univariate 2 x 2 diagnostic test tables and multivariate analysis were performed. RESULTS: A set of eight questionnaire items had an overall predictive power of 73.7%. Two of these were highly specific: 'missed meals due to lack of funds', and the clinical co-occurrence of medical conditions potentially related to poor nutrition. The Michigan Alcohol Screening Test and serum gamma glutamyl transferase were moderately predictive. CONCLUSIONS: Screening that combines socio-demographic, clinical and biological factors, and/or standardized questionnaires, could improve early recognition of thiamine deficiency.