Responses to the AUDIT questionnaire in the population-based Tromsø surveys as predictor of a diagnosis of alcohol use disorder in Norwegian central health registries—an NCDNOR study

Alcohol use and alcohol use disorder (AUD) are major contributors to global morbidity and mortality. The Alcohol Use Disorders Identification Test (AUDIT) is often used for screening of alcohol use and potential alcohol problems, but less is known whether AUDIT can predict a diagnosis of AUD. Responses to the AUDIT questionnaire (N = 29 278) from two waves of a population health survey (The Tromsø study) were used to predict a diagnosis of AUD in national health registries over the following three years. Covariates included age, sex, educational level, family income, and mental health score. Overall, 13%-15% scored above the lowest level on AUDIT, with slightly higher figures in males and younger adults, among those with higher education, or with higher mental distress. Few were represented in national health registries (2.1% and 2.7% of these cases in the primary and specialist healthcare, respectively), but with higher figures among those with the highest AUDIT scores. Being female, of older age, having a lower income, and reporting more mental health symptoms increased the probability of receiving an AUD diagnosis. Younger age, male gender, higher education, and higher mental health score predicted higher AUDIT scores, but few, even with high AUDIT scores, were represented in national health registries with an AUD diagnosis. Furthermore, with a high AUDIT score, factors such as older age, lower income, and lower education increased the likelihood of receiving an AUD diagnosis. This suggests that relying on national health registries to monitor alcohol morbidity may be challenging.