McLennan John D, Braunberger Peter
Scientist, Children's Hospital of Eastern Ontario - Research Institute; Research Chair in Child and Adolescent Psychiatry, Department of Psychiatry, University of Ottawa; Adjunct Associate Professor, Department of Pediatrics, University of Calgary.
Assistant Professor, Northern Ontario School of Medicine, Thunder Bay, Ontario.
J Can Acad Child Adolesc Psychiatry. 2017 Fall;26(3):179-183. Epub 2017 Oct 1.
A new Fetal Alcohol Spectrum Disorder (FASD) guideline was published in the Canadian Medical Association Journal in 2016. This is relevant to the mental health field as mental health symptoms and psychiatric disorders are often identified as associated with and/or part of FASD presentations. Unfortunately, the new guideline has not advanced understanding of the interface between FASD and mental health problems; rather it may contribute to additional confusion. For example, a new recommendation to include additional mental health symptoms, such as anxiety and affect dysregulation, as manifestations contributing to a diagnosis of FASD is particularly concerning given the paucity of evidence supporting this assertion and the potential to distort delivery of mental health interventions for mental health problems. In addition, the guideline recommendation for introducing an "at risk for FASD" designation is not without risk. An appeal is made for greater scrutiny in the construction of diagnostic criteria and guidelines and for a more careful delineation of causal relationships and comorbidities to better inform the delivery of evidence-based mental health care.
2016年，一项新的胎儿酒精谱系障碍（FASD）指南发表在《加拿大医学协会杂志》上。这与心理健康领域相关，因为心理健康症状和精神障碍常被认定与FASD的表现相关及/或属于其一部分。不幸的是，新指南并未增进对FASD与心理健康问题之间界面的理解；相反，它可能会造成更多混乱。例如，一项新建议将焦虑和情感失调等更多心理健康症状纳入作为有助于FASD诊断的表现，鉴于支持这一论断的证据匮乏以及可能扭曲针对心理健康问题的心理健康干预的提供，这尤其令人担忧。此外，引入“FASD风险”认定的指南建议并非没有风险。呼吁在构建诊断标准和指南时进行更严格的审查，并更仔细地界定因果关系和共病情况，以便为提供循证心理健康护理提供更好的信息。
