A primary care physician screens a 50-year-old man with the CAGE questionnaire. He answers yes to two of the four questions. What does this result indicate?
- A Normal drinking, no further action needed
- B Clinically significant alcohol problem warranting further assessment ✓
- C Diagnostic of alcohol dependence requiring immediate detoxification
- D Only valid if all four answers are positive
Correct answer: B. Clinically significant alcohol problem warranting further assessment
Explanation
In Indian exam convention, two or more positive responses on CAGE are considered clinically significant and indicate a probable alcohol problem that needs further evaluation. A score of 1 is suspicious, 2 or more is significant, and 3 to 4 is highly suggestive of alcoholism. CAGE is a screening tool, not a diagnostic instrument, so it does not by itself diagnose dependence or mandate detoxification, and a single negative answer does not exclude pathology.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
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