Psychiatry and Psychotherapy, Vitos-Klinikum Herborn, Austr. 40, 35745, Herborn, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University, Halle-Wittenberg, Halle, Germany.
Eur Arch Psychiatry Clin Neurosci. 2018 Apr;268(3):219-229. doi: 10.1007/s00406-017-0801-2. Epub 2017 Apr 24.
Alcohol use disorders (AUD) have a high comorbidity with mental disorders. Vice versa, alcohol consumption plays an important role in affective disorders, anxiety disorders, ADHD, schizophrenic psychosis, and other mental disorders. In developing the current interdisciplinary, evidence-based treatment guideline on screening, diagnostics, and treatment of AUD, available research on comorbid mental diseases in AUD has been compiled to generate recommendations for treatment. The guideline was prepared under the responsibility of the German Association for Psychiatry, Psychotherapy, and Psychosomatics (DGPPN) and the German Association for Addiction Research and Therapy (DG-Sucht). To meet the methodological criteria for the highest quality guidelines ("S3-criteria") as defined by the Association of Scientific Medical Societies in Germany (AWMF), the following criteria were employed: (1) a systematic search, selection, and appraisal of the international literature; (2) a structured process to reach consensus; and (3) inclusion of all relevant representatives of future guideline users. After assessing and grading the available literature, the expert groups generated several recommendations for the screening, diagnosis, and treatment of comorbid mental disorders. These recommendations were subdivided into psycho-, pharmaco-, and combination therapies. These are the first guidelines ever to make specific treatment recommendations for comorbid mental diseases in AUD. The recommendations extend to different treatment approaches including diagnostics and settings to present available effective and state-of-the-art treatment approaches to clinicians. Hitherto, many clinical constellations have not been addressed in research. Therefore, recommendations for future research are specified.
酒精使用障碍(AUD)与精神障碍的共病率很高。相反,酒精消费在情感障碍、焦虑障碍、ADHD、精神分裂症和其他精神障碍中起着重要作用。在制定当前跨学科、基于证据的 AUD 筛查、诊断和治疗指南时,编译了 AUD 中合并精神疾病的现有研究,以生成治疗建议。该指南由德国精神病学、心理治疗和身心医学协会(DGPPN)和德国成瘾研究和治疗协会(DG-Sucht)负责编写。为了满足德国科学医学协会联合会(AWMF)定义的最高质量指南(“S3 标准”)的方法学标准,采用了以下标准:(1)系统搜索、选择和评估国际文献;(2)达成共识的结构化流程;(3)包括未来指南使用者的所有相关代表。在评估和分级现有文献后,专家组针对合并精神障碍的筛查、诊断和治疗提出了若干建议。这些建议分为心理、药物和联合治疗。这些是有史以来首次针对 AUD 合并精神疾病提出具体治疗建议的指南。这些建议扩展到不同的治疗方法,包括诊断和治疗环境,为临床医生提供现有的有效和最先进的治疗方法。迄今为止,许多临床情况在研究中都没有得到解决。因此,指定了未来研究的建议。