Duffy J D
Department of Psychiatry, Allegheny General Hospital, Medical College of Pennsylvania, Pittsburgh, USA.
Can J Psychiatry. 1995 Jun;40(5):257-63.
Alcohol has neurotoxic effects that frequently result in significant sensorimotor and cognitive deficits. These cognitive deficits may have profound implications for the behaviour and treatment of patients who abuse alcohol. In particular, the deficits in executive cognition that are typical of alcoholic dementia result in difficulties with planning, insight and impulse control. These deficits are frequently misinterpreted as alcoholic denial and are therefore assumed to have a psychodynamic basis. This paper reviews the neurological substrates for insight and self-monitoring and discusses a possible pathophysiology for a subgroup of alcoholic patients who exhibit alcoholic denial. Implications of this model for the evaluation and treatment of alcoholic patients are discussed.
酒精具有神经毒性作用，常常导致明显的感觉运动和认知缺陷。这些认知缺陷可能对酗酒患者的行为和治疗产生深远影响。特别是，酒精性痴呆典型的执行认知缺陷会导致计划、洞察力和冲动控制方面的困难。这些缺陷常常被误解为酗酒者的否认，因此被认为具有心理动力学基础。本文回顾了洞察力和自我监测的神经学基础，并讨论了表现出酗酒否认的一部分酒精性患者可能的病理生理学。还讨论了该模型对酒精性患者评估和治疗的意义。
