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Abstract
Aims
Our aim was to adapt the Clinical Institute of Withdrawal Assessment for Alcohol scale (CIWA-Ar) into Estonian and test its reliability and validity.
Methods
A total of 72 patients with alcohol withdrawal syndrome participated in the study. In order to assess the interrater reliability, at first assessment the CIWA-Ar was simultaneously completed by two nurses. In order to assess the sensitivity of the CIWA-Ar to the changes in the severity of the withdrawal syndrome, as well as its correlations to several indices characterizing the subjects’ current condition, the CIWA-Ar, the Clinical Global Impression Severity subscale (CGI-S), the visual analogue scales for the assessment of the general feeling of malaise, anxiety and depression were filled in and the vital signs were measured at inclusion, in 4 h and after the withdrawal syndrome had been resolved.
Results
The intraclass correlation coefficient (ICC) for the Estonian version of the CIWA-Ar total score, used as an indicator of interrater reliability, was excellent. The CIWA-Ar had significant correlations with the psychiatrists’ CGI-S ratings of the severity of the patient’s condition at all assessment points. Significant correlations were also found between CIWA-Ar and patients’ self-ratings, the highest correlations found with self-rated anxiety and general feeling of malaise. CIWA-Ar total score did not correlate with simultaneously measured heart rate, systolic and diastolic blood pressure at the first assessment. At the second assessment, heart rate had a significant correlation with the CIWA-Ar total score.
Conclusion
Our study provides confirmation that the CIWA-Ar tool is well applicable in the Estonian language and culture setting.
Acknowledgments
The authors would like to thank nurses and doctors of the Tartu University Hospital Psychiatry Clinic who participated in the data collection. We are also grateful to the patients who took part in this research.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
Data and material are available upon request.
Additional information
Funding
Notes on contributors
Teelia Rolko
Teelia Rolko, MD, is currently a psychiatrist and head of Addiction Center, Psychiatry Clinic, Tartu University Hospital. Her main interests include treatment and management of dual diagnosis.
Teve Rauks-Pärgmäe
Teve Rauks-Pärgmäe, MD is currently a psychiatrist at the Addiction Center, Psychiatry Clinic, Tartu University Hospital. Her main interests include role of personality traits in maintenace and treatment of substance use disorders.
Anu Aluoja
Anu Aluoja, PhD, is currently a visiting research fellow at the Department of Psychiatry, Institute of Clinical Medicine, University of Tartu, and a clinical psychologist at Psychiatry Clinic, Tartu University Hospital. Her main interests include psychological assessment, and role of personality traits in maintenance and treatment of mood, anxiety and substance use disorders.
Innar Tõru
Innar Tõru, MD, PhD, is currently an associate professor of psychiatry at the Department of Psychiatry, Institute of Clinical Medicine, University of Tartu, and a psychiatrist at Psychiatry Clinic, Tartu University Hospital. His main interests include neurobiological underpinnings of mood and anxiety disorders, as well as a role of personality traits in maintenance and treatment of mood, anxiety and substance use disorders.
Sven Janno
Sven Janno, MD, PhD, is currently an associate professor and head of Department of Psychiatry in University of Tartu and a psychiatrist at Psychiatry Clinic, Tartu University Hospital. His main research interests include bipolar disorder etiology and substance abuse disorders.