Clinical Neuropsychology samenvatting chapter 18
Alcoholgerelateerde cognitieve stoornissen
18.1 Inleiding
Western cultures → alcohol consumption is widely accepted
- 77.6% of Dutch adults have consumed an alcoholic beverage in the last year
- 6.9% of Dutch adults drink excessively
Excessive drinkers are:
- Women → more than 14 glasses of alcohol per week
- Men → more than 21 glasses of alcohol per week
- Fluitje bier, small glass wine, borrelglas strong booze
Depending on the amount of use, alcohol consumption can lead to:
- Increased risk of cardiovascular disease
- Specific forms of cancer
- Diseases in the gastrointestinal system
Causes chronic inflammatory reactions throughout the body
Indirect consequences → injuries and death due to accidents
18.2 Stoornis in het gebruik van alcohol
Even light consumption (1 to 8 glasses per week) can lead to health damage and even
be classified as alcohol dependent
The terms “alcohol addiction” and “alcoholism” are not used anymore in the DSM-5, due
to stigmatisation around the word “addict”
Definition of alcohol use disorder according to the DSM-5 → A problematic pattern of
alcohol use that leads to clinical significant impairments or distress
11 symptoms with 3 variants:
→ mild alcohol use disorder (2 to 3 symptoms)
→ moderate alcohol use disorder (3 to 4 symptoms)
→ severe alcohol use disorder (more than 6 symptoms)
Treatment → inpatient or outpatient addiction services (klinisch / poliklinisch)
Short interventions to stop or reduce alcohol consumption is effective for all three groups
, Groups that have been admitted to specialised mental health care → interventions are
insufficient, due to the complexity of the psychological and social problems
Criterion (short version)
1 Drinking more or longer than intended
2 Desire or unsuccessful efforts to cut down/control
3 Much time spent obtaining, using, or recovering
4 Craving for alcohol
5 Failure to fulfil major role obligations
Continued use despite social/interpersonal
6
problems
7 Giving up/reducing important activities
8 Use in physically hazardous situations
9 Use despite physical/psychological problems
10 Tolerance (need more for effect or reduced effect)
11 Withdrawal (syndrome or use to relieve it)
18.3 Alcohol-related cognitive disorder
Alcohol-related cognitive disorder → umbrella concept
- only encompasses the description of long-term cognitive impairments
DSM-5 → classified as mild or major alcohol-related neurocognitive disorder
Alcohol-related brain damage (ARBD) → brain damage caused by alcohol consumption
- the term is sometimes also used for patients with cognitive impairments, without
brain imaging having taken place
Term alcohol-related cognitive disorder is more favourable, as it does not necessarily
imply that alcohol is the cause
Acute cognitive effects:
- Under the influence → brain functions sub-optimally
- Excessive drinking → risk factor for cortical atrophy due to white matter
demyelination
Malnutrition with vitamin deficiencies
--> Can even lead to dementia
Alcoholgerelateerde cognitieve stoornissen
18.1 Inleiding
Western cultures → alcohol consumption is widely accepted
- 77.6% of Dutch adults have consumed an alcoholic beverage in the last year
- 6.9% of Dutch adults drink excessively
Excessive drinkers are:
- Women → more than 14 glasses of alcohol per week
- Men → more than 21 glasses of alcohol per week
- Fluitje bier, small glass wine, borrelglas strong booze
Depending on the amount of use, alcohol consumption can lead to:
- Increased risk of cardiovascular disease
- Specific forms of cancer
- Diseases in the gastrointestinal system
Causes chronic inflammatory reactions throughout the body
Indirect consequences → injuries and death due to accidents
18.2 Stoornis in het gebruik van alcohol
Even light consumption (1 to 8 glasses per week) can lead to health damage and even
be classified as alcohol dependent
The terms “alcohol addiction” and “alcoholism” are not used anymore in the DSM-5, due
to stigmatisation around the word “addict”
Definition of alcohol use disorder according to the DSM-5 → A problematic pattern of
alcohol use that leads to clinical significant impairments or distress
11 symptoms with 3 variants:
→ mild alcohol use disorder (2 to 3 symptoms)
→ moderate alcohol use disorder (3 to 4 symptoms)
→ severe alcohol use disorder (more than 6 symptoms)
Treatment → inpatient or outpatient addiction services (klinisch / poliklinisch)
Short interventions to stop or reduce alcohol consumption is effective for all three groups
, Groups that have been admitted to specialised mental health care → interventions are
insufficient, due to the complexity of the psychological and social problems
Criterion (short version)
1 Drinking more or longer than intended
2 Desire or unsuccessful efforts to cut down/control
3 Much time spent obtaining, using, or recovering
4 Craving for alcohol
5 Failure to fulfil major role obligations
Continued use despite social/interpersonal
6
problems
7 Giving up/reducing important activities
8 Use in physically hazardous situations
9 Use despite physical/psychological problems
10 Tolerance (need more for effect or reduced effect)
11 Withdrawal (syndrome or use to relieve it)
18.3 Alcohol-related cognitive disorder
Alcohol-related cognitive disorder → umbrella concept
- only encompasses the description of long-term cognitive impairments
DSM-5 → classified as mild or major alcohol-related neurocognitive disorder
Alcohol-related brain damage (ARBD) → brain damage caused by alcohol consumption
- the term is sometimes also used for patients with cognitive impairments, without
brain imaging having taken place
Term alcohol-related cognitive disorder is more favourable, as it does not necessarily
imply that alcohol is the cause
Acute cognitive effects:
- Under the influence → brain functions sub-optimally
- Excessive drinking → risk factor for cortical atrophy due to white matter
demyelination
Malnutrition with vitamin deficiencies
--> Can even lead to dementia