Wetterling T
Klinik für Psychiatrie und Psychotherapie I der Johann-Wolfgang-Goethe-Universität, Frankfurt, Germany.
Psychiatr Prax. 2001 Sep;28(6):257-61. doi: 10.1055/s-2001-16876.
Epidemiological studies show that alcoholics have a high life-time prevalence of psychiatric illnesses, particularly of anxiety, depressive and schizophrenic disorders. But the complex relationships between elevated alcohol consumption and psychiatric symptomatology frequently Iead to problems in finding diagnosis and thereafter in planning therapeutic strategies.
In this article the results of the studies concerning the medical treatment of psychiatric comorbidity of alcoholics are critically reviewed.
According to the available results a therapy with antidepressive drugs indicated in alcoholics with depression lasting over 14 days. Anxiety disorders seem to have little influence on the course of alcoholism. Thus, an anxiolytic medication has to be considered carefully in view of the addiction potency of tranquilizers. There is a paucity of data concerning drug treatment of schizophrenics with alcohol abuse. Thus far only a few studies have shown an effect of a drug treatment of the psychiatric comorbidity on the drinking behavior.
There is a lack of studies on specific treatment strategies of psychiatric comorbid alcoholics, particularly of schizophrenics with alcohol abuse.
流行病学研究表明,酗酒者一生中患精神疾病的比例很高,尤其是焦虑症、抑郁症和精神分裂症。但是,饮酒量增加与精神症状之间的复杂关系常常导致在诊断以及随后制定治疗策略方面出现问题。
本文对有关酗酒者精神疾病合并症药物治疗的研究结果进行了批判性综述。
根据现有结果,对于患有持续超过14天抑郁症的酗酒者,使用抗抑郁药物进行治疗。焦虑症似乎对酗酒过程影响不大。因此,鉴于镇静剂的成瘾性,必须谨慎考虑使用抗焦虑药物。关于对同时患有酒精滥用问题的精神分裂症患者进行药物治疗的数据很少。到目前为止,只有少数研究表明对精神疾病合并症进行药物治疗对饮酒行为有影响。
缺乏关于患有精神疾病合并症的酗酒者,尤其是同时患有酒精滥用问题的精神分裂症患者的具体治疗策略的研究。