Alcohol consumption and the CAGE test in outpatients with schizophrenia or Schizoaffective disorder and in the general population

We conducted a survey of 151 outpatients with schizophrenia or schizoaffective disorder in Geneva, Switzerland, in 2000, and a mail survey in a representative sample of the general population of Geneva in 1996 (n = 742), to compare alcohol consumption and alcoholism in these two samples. Fewer patients with schizophrenia than participants in the general population drank alcohol daily (9.9% vs. 18.3%, p < 0.001). Excluding participants who said they currently never drank, alcohol consumption was similar in both groups (3 vs. 4 glasses/week, p = 0.22). However, more patients with schizophrenia than participants in the population sample had a CAGE score >= 2 (21.2% vs. 10.1%, p < 0.001), indicating a suspicion of alcoholism. Thus, asking about alcohol consumption produced different results from assessing hidden alcoholism with the CAGE. Either patients with schizophrenia underreported their alcohol consumption, or the CAGE produced higher scores in these patients, for any given level of alcohol consumption. Previous research has shown, however, that the CAGE is a valid test in patients with schizophrenia, which suggests that in Geneva, alcoholism is more prevalent in patients with schizophrenia than in the general population.