Rivista di psichiatria最新文献

Drinking alcohol during pregnancy can cause congenital disabilities. J. Roquette, P. Lemoine and K.L. Jones were the first to describe these effects. In 1973, Jones and Smith coined the term Fetal Alcohol Syndrome to describe children with facial anomalies, poor growth, and learning difficulties. The caution against drinking during pregnancy has existed for centuries, including in The Bible (Judges 13:3-4). Maternal alcohol consumption is linked to congenital disabilities. To ensure safety, it is advised to abstain from alcohol during pregnancy. Fetal Alcohol Spectrum Disorder (FASD) was observed in paintings from the mid-19th century when artists began depicting moments and characters from everyday life. In 2005-2006, Italy conducted a groundbreaking study on FASD, the first in Europe. The study resulted in valuable research on FASD, contributing to prevention efforts. Unfortunately, diagnosing FASD remains a challenge in Italy. Early diagnosis and treatment are critical, and increasing the number of authorized centers to diagnose FASD is necessary to improve care. Educating ourselves about FASD is the key to creating a world where affected children receive the care they need. These guidelines include nine works dealing with all FASD aspects such as prevention, the effects on cognition, the epidemiology, the diagnostic criteria, the clinical aspects, the general effects on the body, the available treatments and the methods of detecting alcohol abuse in pregnant women.

Fetal Alcohol Spectrum Disorders (FASD) are pervasive disorders that impact various domains of functioning, including self-esteem, familiar and peer relationships, and academic success. The high rate of comorbidity may contribute to delayed diagnosis and treatment. Early diagnosis and intervention that aim at primary symptoms may prevent secondary disabilities and improve the outcomes. No intervention emerged as maximally effective across all symptoms and domains. Consequently, the complex pathophysiology of FASD emphasizes the need for individualized assessment and treatment by using a multimodal approach to intervention.

Fetal alcohol spectrum disorders (FASD) are a significant global challenge characterized by complex diagnosis and research. The diagnostic process is complicated due to overlapping symptoms with other conditions, as well as factors such as maternal nutrition, socioeconomic status, and mental health, which can affect the severity of FASD traits differently in individuals. Risky drinking behaviors are prevalent in young adults, especially those aged 20-24, which coincides with high rates of unplanned pregnancies, increasing the risk of FASD. Specific subpopulations, such as children in care facilities and specialized clinical settings, face higher FASD prevalence. Preventing alcohol consumption during pregnancy is crucial for maternal and fetal well-being. Yet approximately 10% of women worldwide continue to drink during pregnancy, with notably high rates in the European Region. Young adults, especially in countries like Italy, continue to consume alcohol despite legal restrictions, mirroring the drinking patterns of men and raising concerns for fetal health and development. Research findings regarding alcohol’s risks during pregnancy vary, emphasizing the need for increased education on this issue. Ethylglucuronide (EtG) is a reliable biomarker for monitoring alcohol intake during pregnancy, suggesting regular urine examinations throughout each trimester. Proactive education campaigns, particularly in educational institutions, and establishing early diagnosis centers are recommended to address FASD effectively.

Fetal Alcohol Spectrum Disorders (FASD) is an encompassing term used to describe a range of afflictions brought about by the consumption of alcohol during gestation. The detrimental effects primarily manifest in the central nervous system, growth, and distinctive facial features. Given that there are no known treatments for FASD, the meticulous screening for this condition in the earliest stages of pregnancy bears immense significance, ensuring the avoidance of the grievous consequences stemming from exposure to alcohol in utero. Screening measures for FASD encompass the assessment of alcohol biomarkers such as Phosphatidylethanol (PEth) in the maternal bloodstream, Fatty Acid Ethyl Esters (FAEEs) in the meconium, and Ethyl Glucuronide (EtG) in the meconium, maternal urine and hair. In particular, urinary EtG is highly sensitive and could be routinely used in pregnant women for detecting also occasional drinking. Questionnaire evaluations including AUDIT-C, T-ACE, and TWEAK, alongside a detailed Food Diary method to identify alcohol misuse and high-risk pregnancies, are also available. However, these questionnaires might provide an inadequate reflection of alcohol consumption in women due to their inclination to dissemble to comply with prevailing sociocultural expectations. Hence, this comprehensive review advocates for the indispensable integration of alcohol biomarkers detection in the course of pregnancy monitoring, as it constitutes a valuable tool for facilitating FASD screening.

The umbrella term Fetal Alcohol Spectrum Disorders (FASD) brings together under its definition a heterogeneous continuum of disabilities linked by a common etiology and pathogenesis: exposure to alcohol during intrauterine life. Despite extensive research, definitive toxic thresholds remain elusive, underscoring the recommendation for complete alcohol abstinence during pregnancy and lactation. FASD poses diagnostic challenges due to its varied presentations and heterogeneous phenotype. Consequently, no singular diagnostic guideline exists, with multiple expert-driven diagnostic systems globally available. This review aims to synthesize recent and notable guidelines facilitating FASD diagnosis. While efforts were made to include the latest diagnostic systems, determining which scheme is best applied to each individual patient population necessitates clinician discretion. In Italy, the guidelines proposed by Hoyme, revised in 2016, are commonly utilized, yet comparative analysis among guidelines offers valuable insights into their historical context and diagnostic utility. Our discussion explores both similarities and discrepancies among systems for diagnosing FASD, shedding light on their evolution and practical application. The objective of our work was to compare in a practical and precise manner the various existing guidelines used globally regarding the diagnosis of FAS. Our review therefore proposes the diagnostic criteria used by the various working groups and compares them, trying to create a practical comparison between the various guidelines, identifying differences and similarities.

Alcohol consumption during pregnancy poses significant risks to maternal and fetal health, contributing to a range of adverse outcomes collectively known as Fetal Alcohol Spectrum Disorders (FASD). This article reviews evidence-based preventive strategies aimed at mitigating the detrimental effects of prenatal alcohol exposure. Drawing upon literature from various disciplines, interventions are categorized according to their level of prevention: universal, selective, and indicated. Training of personnel and availability of official guidelines are a pre-requisite for effective prevention. Universal prevention strategies include public health campaigns, educational initiatives, and policy interventions aimed at raising awareness about the risks of prenatal alcohol exposure and promoting abstinence during pregnancy. Integrating alcohol screening and brief intervention protocols into routine prenatal care settings can help identify and support women who may be at risk of alcohol use during pregnancy. Consequently, selective and indicated interventions, identifying drinking women, may provide targeted support to pregnant women at risk. Indicated prevention interventions also encompass treatment and rehabilitation strategies for women with a known alcohol abuse problem or who have already had alcohol-exposed pregnancies. Finally, ethical issues related to the stigma associated with alcohol consumption during pregnancy are highlighted, to be considered for an effective mother and child health promotion.

Fetal Alcohol Spectrum Disorders (FASD) are a condition that arises when a person is exposed to alcohol during pregnancy. The main clinical manifestations include craniofacial anomalies, growth retardation, birth defects and change in brain structure and function. These alterations can result in deficits across various domains such as cognition, executive function, memory, vision, hearing, motor skills, behavior, and social adaptation. The effects of alcohol extend beyond the brain, affecting other systems including sensory organs, heart, and kidneys. Given that diagnosing FASD involves excluding other conditions, it is crucial for physicians to be familiar with its main characteristics to facilitate early identification and implement appropriate health strategies for the patient. Moreover, there is a pressing need for primary prevention strategies centered around raising awareness about the risks associated with alcohol consumption during pregnancy. The articles for this report aimed to analyze and evaluate studies focusing on the clinical features observed in FASD children were sourced from online databases such as Medline, Medline Complete and PubMed, covering literature published between 1981 and 2024, written in English, using search terms such as fetal alcohol spectrum disorders, fetal alcohol syndrome, prenatal alcohol exposure, and alcohol-related birth defects. The evidence gathered underscores that prenatal alcohol exposure primarily affects the brain and its functions, resulting in severe impacts. Furthermore, abnormalities in other vital organs such as the sensory, cardiovascular, and renal systems are frequently observed.

Fetal alcohol spectrum disorders (FASDs) refer to a group of clinical conditions that occur in a person exposed to alcohol before birth. Neuroimaging shows abnormalities in brain structure, cortical development, white matter microstructure, and functional connectivity in individuals with FASD. These abnormalities modify the normal developmental trajectories resulting in deficits in cognition and behavior across several domains, including general intelligence, memory, language, attention, learning, visuospatial abilities, executive functioning, fine and gross motor skills, and social and adaptive functioning. This paper provides a review of the cognitive and behavioral outcomes of prenatal alcohol exposure. Updates data on FASD-specific neurobehavioral profile and its potential as a diagnostic tool will then be presented.

Fetal Alcohol Spectrum Disorders (FASD) encompass a range of conditions caused by prenatal alcohol consumption, leading to physical, behavioral, and learning challenges. It is a significant cause of preventable mental disability, with a prevalence rate of 7.7 cases per 1,000 individuals in the Western world. FASD includes various categories such as alcohol-related neurodevelopmental disorders (ARND), alcohol-related birth defects (ARBD), partial fetal alcohol syndrome (pFAS), and FAS. Mortality is primarily linked to external causes and individuals with FAS may have a projected lifespan of around 34 years. This review highlights the key features of FASD, including neurological impact, behavioral abnormalities, placental and congenital malformations, organic abnormalities, and hormonal and immune disruption. Additionally, potential therapeutic approaches for FASD are briefly discussed based on the different manifestations. Prevention remains the most effective strategy to reduce its incidence, although the general population’s understanding of this topic is currently insufficient. Timely diagnosis and intervention are crucial as they can significantly enhance outcomes through appropriate support and management strategies. Increasing awareness among citizens about the detrimental effects of alcohol use disorders on newborn health is of utmost importance.

Fetal Alcohol Spectrum Disorders (FASD) encompass a spectrum of clinical manifestations resulting from maternal alcohol consumption during pregnancy. This condition presents with diverse anomalies including intrauterine and extrauterine growth retardation, phenotypic abnormalities, cerebral structural anomalies, cognitive delays, and behavioral abnormalities. Regrettably, FASD remains an irreversible and epigenetic condition, with total abstention from alcohol during pregnancy being the sole effective preventive measure due to the absence of a viable therapy. Diagnosis typically occurs postnatally, based on a combination of alcohol exposure history and the presence of aforementioned physical or behavioral abnormalities. The diagnosis is not always easy to make even in the post-natal period due to the different subtypes of existing FASD. Indeed, only some of these subtypes cause behavioral or neurodevelopmental abnormalities in the absence of pathognomic physical anomalies. Although the diagnostic criteria are useful, unfortunately, there is a heterogeneity resulting from the different guidelines that are used in different countries. The aim of our review, based on a literature search of online databases including Medline, Medline Complete, PubMed, and Google Scholar, is therefore to provide an overview of the diagnostic criteria used in Italy.