Masood Barkat, Lepping Peter, Romanov Dmitry, Poole Rob
Betsi Cadwaladr University Health Board (BCUHB), Heddfan Unit, Wrexham Maelor Hospital, Wrexham, Wales LL13 7TD, UK.
Centre for Mental Health and Society (University of Bangor), Wrexham Medical Institute, Technology Park Centre, Croesnewydd Road, Wrexham, Wales LL13 7YP, UK.
Alcohol Alcohol. 2018 May 1;53(3):259-267. doi: 10.1093/alcalc/agx090.
To evaluate the effectiveness of evidence based treatments for alcohol-induced psychotic disorder (AIPD) as described by ICD-10 and DSM-5, a condition that is distinct from schizophrenia and has a close relationship with alcohol withdrawal states.
Systematic review using PRISMA guidelines.
Of 6205 abstracts found, fifteen studies and ten case reports met criteria and were examined. Larger studies examined the use of first-generation antipsychotic drugs, reporting full or partial remission in most patients. Newer case reports report similar results using second generation antipsychotic drugs. Novel treatments, such as those acting on GABA receptors reported low numbers of patients in remission. Some large studies report the successful use of standard alcohol withdrawal treatments.
The findings of our systematic review are inconclusive. There was significant heterogeneity between and within studies. Significant publication bias is likely. Randomized control trials of more carefully delineated samples would produce evidence of greater clinical utility, for example, on differential effectiveness of antipsychotics and optimal length of standard alcohol withdrawal treatments. AIPD patients who show poor treatment responses should be studied in greater depth.
This systematic review of alcohol-induced psychotic disorder treatment found 15 studies and 10 case reports of relevance. Older studies of first-generation antipsychotics reported full or partial remission in most patients, as did newer studies with second-generation antipsychotics. Novel drugs reported low remission rates. Standard alcohol withdrawal treatments were successful.
评估国际疾病分类第10版（ICD - 10）和精神疾病诊断与统计手册第5版（DSM - 5）所描述的酒精所致精神障碍（AIPD）循证治疗的有效性。AIPD是一种有别于精神分裂症且与酒精戒断状态密切相关的疾病。
采用系统评价与Meta分析的首选报告项目（PRISMA）指南进行系统评价。
在检索到的6205篇摘要中，15项研究和10篇病例报告符合标准并纳入分析。规模较大的研究考察了第一代抗精神病药物的使用情况，报告显示大多数患者实现了完全或部分缓解。较新的病例报告使用第二代抗精神病药物也报告了类似结果。新型治疗方法，如作用于γ-氨基丁酸（GABA）受体的药物，报告的缓解患者数量较少。一些大型研究报告了标准酒精戒断治疗的成功应用。
我们系统评价的结果尚无定论。研究之间和研究内部存在显著异质性。很可能存在显著的发表偏倚。对更精确界定样本的随机对照试验将产生更具临床实用性的证据，例如，关于抗精神病药物的不同疗效以及标准酒精戒断治疗的最佳时长。对治疗反应不佳的AIPD患者应进行更深入的研究。
这项对酒精所致精神障碍治疗的系统评价发现了15项相关研究和10篇病例报告。关于第一代抗精神病药物的早期研究报告大多数患者实现了完全或部分缓解，使用第二代抗精神病药物的较新研究也是如此。新型药物报告的缓解率较低。标准酒精戒断治疗取得了成功。
