The medical history (history of illness) represents an important component in the diagnosis of alcohol dependence.
Family history
- What is the general health of your family members?
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation (e.g., disputes with life partner, separation, divorce)?
- Decline in performance, unexcused absence from work, job loss.
- Accidents, injuries and alcohol influence.
- Housing situation (e.g. homelessness).
- Loss of driving license
Current medical history/systemic history (somatic and psychological complaints).
- How often do you drink 6 or more alcoholic beverages on any one occasion?
- Do you ever drink alcohol first thing in the morning to help start the day?
- When do you drink alcohol for the first time in the day?
- How much alcohol do you drink on average per day?
- How long have you been drinking alcohol regularly?
- Do you notice an urge to consume alcohol?
- Is there a current occasion of alcohol consumption, especially relapse?
- Have you noticed any physical limitations since you started drinking alcohol regularly?
Vegetative anamnesis incl. nutritional anamnesis.
- Has your appetite changed?
- Have you noticed any unwanted change in weight?
- Have you noticed any changes in digestion and/or water excretion?
- Do you suffer from sleep disturbances?
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
- Do you use drugs? If yes, what drugs (e.g., hashish and marijuana) and how often per day or per week?
Self-history incl. medication history.
- Pre-existing conditions: Have you already participated in outpatient or partial inpatient withdrawal and detoxification treatments (including medication-assisted measures)? Intoxication and withdrawal complications (e.g., “pathological intoxication,” cerebral seizures, withdrawal delirium)?
- Operations
- Allergies
- Medication history
Further notes
- Questionnaires such as the Alcohol Use Disorders Identification Test (AUDIT, 10 questions) or its short form AUDIT-C (3 questions) are suitable for screening risky alcohol use or alcohol dependence.