Cottencin Olivier, Nandrino Jean-Louis, Karila Laurent, Mezerette Caroline, Danel Thierry
Department of Addictology, University of Lille 2, Faculty of Medicine, University Hospital of Lille, 57 Bd de Metz, 59037 Lille Cedex, France.
Eur Psychiatry. 2009 Apr;24(3):195-200. doi: 10.1016/j.eurpsy.2008.12.003. Epub 2009 Feb 4.
As executive dysfunctions frequently accompany alcohol dependence, we suggest that reports of executive dysfunction in alcoholics are actually due, in some case to a maternal history of alcohol misuse (MHA+). A history of maternal alcohol dependence increases the risk for prenatal alcohol exposure to unborn children. These exposures likely contribute to executive dysfunction in adult alcoholics. To assess this problem, we propose a case-comparison study of alcohol-dependent subjects with and without a MHA.
Ten alcohol-dependent subjects, with a maternal history of alcoholism (MHA) and paternal history of alcoholism (PHA), were matched with 10 alcohol-dependent people with only a paternal history of alcoholism (PHA). Executive functions (cancellation, Stroop, and trail-making A and B tests) and the presence of a history of three mental disorders (attention deficit hyperactivity disorder, violent behavior while intoxicated, and suicidal behavior) were evaluated in both populations.
Alcohol-dependent subjects with MHA showed a significant alteration in executive functions and significantly more disorders related to these functions than PHA subjects. The major measures of executive functioning deficit are duration on task accomplishment in all tests. Rates of ADHD and suicidality were found to be higher in MHA patients compared to the controls.
A history of MHA, because of the high risk of PAE (in spite of the potential confounding factors such as environment) must be scrupulously documented when evaluating mental and cognitive disorders in a general population of alcoholics to ensure a better identification of these disorders. It would be helpful to replicate the study with more subjects.
由于执行功能障碍常伴随酒精依赖出现,我们认为酗酒者执行功能障碍的报告,在某些情况下实际上是由于母亲有酒精滥用史(MHA+)。母亲有酒精依赖史会增加未出生胎儿产前酒精暴露的风险。这些暴露可能导致成年酗酒者出现执行功能障碍。为评估这一问题,我们提出一项对有和没有母亲酒精滥用史的酒精依赖受试者进行病例对照研究。
10名有母亲酗酒史(MHA)和父亲酗酒史(PHA)的酒精依赖受试者与10名只有父亲酗酒史(PHA)的酒精依赖者进行匹配。对两组人群评估执行功能(删字、斯特鲁普以及连线测验A和B)以及三种精神障碍史(注意力缺陷多动障碍、醉酒时的暴力行为和自杀行为)的存在情况。
有MHA的酒精依赖受试者在执行功能方面表现出显著改变,且与这些功能相关的障碍比只有PHA的受试者显著更多。执行功能缺陷的主要衡量指标是所有测试中任务完成的持续时间。与对照组相比,MHA患者中注意缺陷多动障碍和自杀倾向的发生率更高。
由于产前酒精暴露风险高(尽管存在环境等潜在混杂因素),在评估普通酗酒人群的精神和认知障碍时,必须仔细记录MHA史,以确保更好地识别这些障碍。用更多受试者重复该研究将有所帮助。