Preuss U W, Gouzoulis-Mayfrank E, Havemann-Reinecke U, Schäfer I, Beutel M, Mann K F, Hoch E
Nervenarzt. 2016 Jan;87(1):26-34. doi: 10.1007/s00115-015-4378-6.
Alcohol-related disorders have a high comorbidity with mental disorders and vice versa, alcohol consumption plays an important role in affective disorders and schizophrenic psychoses. In developing the current S3 guidelines evidence-based knowledge on the rate and significance of comorbid disorders in alcohol use disorders has been compiled to generate recommendations for treatment.
In preparation for the guidelines, previous international guidelines and a systematic literature search were taken into consideration. Recommendations for various and specific clinical situations were derived from these sources based on evidence grading. Evidence and recommendations were subdivided into psychotherapy, pharmacotherapy and combination therapy, each having differential efficacies in the treatment of psychiatric symptoms and alcohol consumption behavior. Furthermore, a separate treatment pathway was developed for a stepwise approach to affective disorders for both comorbidities.
Appearing for the first time in guidelines are specific treatment recommendations for comorbid mental diseases in alcohol use disorders. These recommendations extend to different treatment approaches including diagnostics and settings, affording clinicians more pragmatic relevance.
酒精相关障碍与精神障碍的共病率很高,反之亦然,饮酒在情感障碍和精神分裂症性精神病中起重要作用。在制定当前的S3指南时,已汇编了关于酒精使用障碍中共病障碍的发生率和重要性的循证知识,以生成治疗建议。
在准备指南时,考虑了以前的国际指南和系统的文献检索。基于证据分级,从这些来源得出针对各种特定临床情况的建议。证据和建议细分为心理治疗、药物治疗和联合治疗,每种治疗在治疗精神症状和饮酒行为方面具有不同的疗效。此外,还制定了一条单独的治疗途径,用于对两种共病的情感障碍采取逐步治疗方法。
酒精使用障碍中共病精神疾病的具体治疗建议首次出现在指南中。这些建议扩展到不同的治疗方法,包括诊断和治疗环境,为临床医生提供了更多实用价值。