Nature Reviews:危险性饮酒和酒精使用障碍(综述)
创作:拍了花宝贝 审核:Johnson 01月05日
  • 酒精使用障碍(AUDs)属于精神综合征,其特征是对饮酒和其他症状的控制受损;
  • AUDs的病因学从生物心理社会框架出发,强调了遗传、神经生物学、心理学和个人的社会和社会背景之间的相互作用;
  • AUDs既受遗传影响(具有复杂的多基因结构),也受环境的影响;
  • 公认的AUDs生物学和心理决定因素包括持续使用后的神经适应性变化、大脑结构和功能的差异以及动机决定因素;
  • 可充分利用筛查、药物治疗、心理干预和政策策略等方式来减少酒精危害。
这是发表在Nature Reviews Disease Primers上的一份综述文章。作者主要围绕危险性饮酒和酒精使用障碍进行阐述,文中概括了酒精标准单位、危险饮酒和酒精使用障碍(AUDs)的定义和人群类别,总结了在世界不同地区酒精消耗量以及AUDs人群比例,同时介绍了酒精滥用造成的全身各处疾病,以及酒精在人体内的主要代谢途径和生物标记物,作者也详细论述了酒精滥用对神经系统的伤害。接下来,作者主要集中于酒精使用障碍的临床诊疗部分内容,介绍了临床诊断依据规范,以及诊断筛查的靶点和范围,也总结了临床治疗药物和对应适应症。同时,作者强调了在酒精使用障碍治疗过程中心理干预措施的必要性。除此之外,作者还论述了酒精使用障碍的成因和因素间可能存在的相互作用。

Hazardous drinking and alcohol use disorders



2022-12-22, Review

Abstract & Authors:展开

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspectives on AUDs apply a biopsychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology, and an individual’s social and societal context. There is strong evidence that AUDs are genetically influenced, but with a complex polygenic architecture. Likewise, there is robust evidence for environmental influences, such as adverse childhood exposures and maladaptive developmental trajectories. Well-established biological and psychological determinants of AUDs include neuroadaptive changes following persistent use, differences in brain structure and function, and motivational determinants including overvaluation of alcohol reinforcement, acute effects of environmental triggers and stress, elevations in multiple facets of impulsivity, and lack of alternative reinforcers. Social factors include bidirectional roles of social networks and sociocultural influences, such as public health control strategies and social determinants of health. An array of evidence-based approaches for reducing alcohol harms are available, including screening, pharmacotherapies, psychological interventions and policy strategies, but are substantially underused. Priorities for the field include translating advances in basic biobehavioural research into novel clinical applications and, in turn, promoting widespread implementation of evidence-based clinical approaches in practice and health-care systems.

First Authors:
James MacKillop

Correspondence Authors:
James MacKillop

All Authors:
James MacKillop,Roberta Agabio,Sarah W Feldstein Ewing,Markus Heilig,John F Kelly,Lorenzo Leggio,Anne Lingford-Hughes,Abraham A Palmer,Charles D Parry,Lara Ray,Jürgen Rehm