Alcohol Use Disorders – a new The Lance Psychiatry Series
Alcohol use disorders are a major cause of morbidity and mortality worldwide, and of immense importance to all mental health professionals.
Purpose of the series
A new The Lancet Series puts heavy alcohol use and alcohol use disorder in clinical and public health contexts, providing clinicians with a concise but comprehensive summary of current knowledge and future directions for research and care.
Content of the series
Topics include screening, brief intervention, and referral for treatment; evidence-based behavioural interventions; medication-assisted treatment; and technology-based and population-level interventions.
The series also covers alcohol use disorder co-occurring with mental health disorders, summarising and exploring hypotheses as to why these conditions so frequently co-exist, and outlining various possible causal pathways.
Articles of the series
Prevention, screening, and treatment for heavy drinking and alcohol use disorder
Justin Knox, Deborah S Hasin, Farren R R Larson, Henry R Kranzler
The Lancet Psychiatry, Vol. 6, No. 12
Summary
Heavy alcohol use and alcohol use disorder are major public health problems. Practitioners not specialising in alcohol treatment are often unaware of the guidelines for preventing, identifying, and treating heavy alcohol consumption and alcohol use disorder. However, a consensus exists that clinically useful and valuable tools are available to address these issues.
The researchers review existing information and developments from the past 5 years in these areas. They also include information on heavy alcohol use and alcohol use disorder among individuals with co-occurring psychiatric disorders, including other drug use disorders.
Areas covered include prevention; screening, brief intervention, and referral for treatment; evidence-based behavioural interventions; medication-assisted treatment; technology-based interventions (eHealth and mHealth); and population-level interventions. The researchers also discuss the key topics for future research.
Psychiatric comorbidities in alcohol use disorder
Alvaro Castillo-Carniglia, Katherine M Keyes, Deborah S Hasin, Magdalena Cerdá
The Lancet Psychiatry, Vol. 6, No. 12
Summary
Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate.
In this Series paper, the researchers examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan.
Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous.
Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.