Mental health issues in fetal alcohol spectrum disorder

Pei, Jacqueline; Denys, Kennedy; Hughes, Janet; Rasmussen, Carmen

doi:10.3109/09638237.2011.577113

Cited by 140 publications

(102 citation statements)

References 39 publications

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“…This is consistent with the high rates of co-morbid psychiatric diagnoses among individuals with PAE (Pei et al, 2011), although surprising to see the low rate of reported anxiety concerns given the high rate of anxiety disorders reported for this population (Olson et al 2009). It is also noteworthy that it was the externalizing concerns, such as antisocial behavior and aggression that were described as the greatest concerns, as opposed to internalizing disorders.…”

Section: Discussionsupporting

confidence: 77%

“…In Canada, the annual cost of supporting persons 0 to 53 years of age with FASD is estimated to be $5.3 billion (Stade et al, 2009). FASD, with mental health comorbidity rates as high as 90% with the most common being depression, mood and anxiety disorders, Attention Deficit Hyperactivity Disorder (ADHD), and Conduct Disorder (CD) (see Pei, Denys, Hughes, & Rasmussen, 2011 for a review). Moreover, these mental health issues appear to be lifelong spanning from childhood (O'Connor, 2001;O'Connor et al, 2002) to adolescence and adulthood (Barr et al, 2006;Spohr & Steinhausen, 1987;Steinhausen & Spohr, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Adaptive Functioning, Social Skills, Mental Health, and Personal Strengths among Adolescents with Prenatal Alcohol Exposure (PAE)

Mariasine¹,

Pei²,

Poth³

et al. 2014

IJPS

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Three key areas of dysfunction reported as having a significant impact on how adolescents with Prenatal Alcohol Exposure (PAE) navigate their teen years and work towards independence are: mental health, social skills, and adaptive functioning. However, little is known about how adolescents with PAE perceive their own functioning relative to others, and what they and others see as potential strengths on which they may build. Participants included 32 adolescents (17 male, 15 female); 31% had confirmed prenatal exposure to alcohol (PAE) and the remaining 69% had a diagnosis of a Fetal Alcohol Spectrum Disorder (FASD). Adolescents and their caregivers completed the following measures: ABAS-2 (adaptive skills), SSIS (social skills), BASC-2 (mental health functioning), and BERS-2 (personal strengths). Overall, caregivers rated adolescents as having significantly more difficulties across all measures assessed when compared to the adolescents. The only area of agreement between caregiver and adolescents prenatally exposed to alcohol was on career strength. The knowledge gained from the results of this exploratory study can help adolescents with PAE better understand themselves and help researchers to better characterize this population.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Adaptive Functioning, Social Skills, Mental Health, and Personal Strengths among Adolescents with Prenatal Alcohol Exposure (PAE)

Mariasine¹,

Pei²,

Poth³

et al. 2014

IJPS

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“…Alcoholics have low folate levels, owing to reduced absorption, and following alcohol consumption, formic acid levels rise and can be neurotoxic. FASD is associated with significant neurological problems such as behavioural, cognitive, and motor impairment (Chokroborty-Hoque et al 2014) depression (Pei et al 2011), and epileptic seizures (Bell et al 2010;Nicita et al 2014). Women who consume alcohol during pregnancy may also have low folic acid and higher formic acid levels that can be teratogenic to the fetus.…”

Section: Discussionmentioning

confidence: 99%

FASD: folic acid and formic acid — an unholy alliance in the alcohol abusing mother

Kapur

Baber

2018

Biochem. Cell Biol.

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Alcohol consumption during pregnancy remains a significant cause of preventable birth defects and developmental disabilities; however, the mechanism of toxicity remains unclear. Methanol is present as a congener in many alcoholic beverages and is formed endogenously. Because ethanol is preferentially metabolized over methanol, it has been found in the sera and cerebro-spinal fluid of alcoholics. Toxicity resulting from methanol has been attributed to formic acid. Formic acid is present in significantly higher quantities in the biofluids of alcoholics. These higher levels can be cytotoxic and cause neuronal cell death. However, the adverse effects can be mitigated by adequate levels of hepatic folic acid, because formic acid elimination depends on folic acid. During pregnancy, folate concentrations are at least 2-fold higher in cord blood then in maternal blood, owing to increased folate requirements. The reverse has been demonstrated in pregnancies with alcohol abuse, suggesting downregulation of folate transporters and low fetal folate levels. Moreover, formic acid can cross the placenta and its adverse effects can be mitigated by folic acid. Thus, the combination of low fetal folate levels and presence of formic acid form a potent cytotoxic combination that may play a significant role in the etiology of fetal alcohol spectrum disorder.Key words: formic acid, methanol, folic acid, FASD, neurotoxicity.Résumé : La consommation d'alcool pendant la grossesse demeure une cause significative de déficiences congénitales et développementales évitables, mais le mécanisme responsable de sa toxicité est encore flou. Le méthanol est présent comme congénère dans plusieurs boissons alcooliques et il est formé de manière endogène. Puisque l'éthanol est préférentiellement métabolisé par rapport au méthanol, ce dernier a été trouvé dans le sérum et le liquide céphalorachidien des personnes alcooliques. La toxicité résultant du méthanol a été attribuée à l'acide formique. L'acide formique est présent en quantité significativement plus élevée dans les liquides biologiques des patients alcooliques. Ces niveaux plus élevés peuvent être cytotoxiques et causer la mort neuronale. Cependant, ces effets nocifs peuvent être atténués par des niveaux appropriés d'acide folique hépatique, car l'élimination d'acide formique dépend de l'acide folique. Durant la grossesse, les concentrations de folate sont au moins deux fois plus élevées dans le cordon ombilical que dans le sang maternel à cause des besoins accrus en folate. L'inverse a été démontré chez les femmes enceintes qui abusent d'alcool, suggérant une régulation à la baisse des transporteurs du folate et de faibles niveaux foetaux de folate. En outre, l'acide formique peut traverser le placenta et ses effets nocifs peuvent être atténués par l'acide folique. Ainsi, de faibles niveaux foetaux de folate et la présence d'acide formique forment une combinaison cytotoxique puissante qui peut jouer un rôle significatif dans l'étiologie de troubles du spectre de l'alcoolisation foet...

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“…Individuals with FASD have an increased susceptibility to mental health disorders, and this vulnerability persists across the lifespan [6,13]; over 90% of the FASD population is thought to experience comorbid mental health problems [48]. Most commonly, individuals with FASD experience depression and anxiety, attention-deficit hyperactivity disorder (ADHD), and conduct disorder (CD), but posttraumatic stress disorder, obsessive-compulsive disorder, oppositional defiance disorder, and bipolar disorder are also reported [48].…”

Section: Mental Health Needsmentioning

confidence: 99%

“…Most commonly, individuals with FASD experience depression and anxiety, attention-deficit hyperactivity disorder (ADHD), and conduct disorder (CD), but posttraumatic stress disorder, obsessive-compulsive disorder, oppositional defiance disorder, and bipolar disorder are also reported [48]. The nature of mental health issues in this population may change across the lifespan with alcohol and drug abuse being a serious concern for adults [48]. Compounding this risk is the fact that adults with FASD rarely access mental health services [49].…”

Section: Mental Health Needsmentioning

confidence: 99%

Interventions for Fetal Alcohol Spectrum Disorder: Meeting Needs Across the Lifespan

Pei¹,

Flannigan²,

Walls³

et al. 2016

Int J Neurorehabilitation Eng

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Background: Fetal Alcohol Spectrum Disorder (FASD) is a complicated disability resulting in a diverse, highneeds population for whom intervention is critical to optimize functional competence and reduce the emergence of adverse outcomes. Researchers have been evaluating intervention efforts for FASD to inform practice and policy decision-making. Objective: The current review provides a synopsis of the current state of evidence for intervention research in FASD, with consideration of how our growing understanding of the unique needs of individuals with FASD might inform future intervention initiatives. Method: A comprehensive literature review was conducted across a number of databases using multiple search terms linking FASD and intervention. Results: Existing evidence-based interventions are limited and focus predominantly on the school-aged population, thereby neglecting adolescents and adults. Future research efforts are needed to support individuals with FASD across the entire lifespan, particularly during transitions and for individuals involved in the legal system. Conclusion: As the field of FASD continues to grow, so must the quality and quantity of intervention research. It is through cross-discipline intervention research efforts that the evidence supporting best practices will be established, and policies can be implemented to reflect best uses of available funds to support this population.

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Mental health issues in fetal alcohol spectrum disorder

Cited by 140 publications

References 39 publications

Adaptive Functioning, Social Skills, Mental Health, and Personal Strengths among Adolescents with Prenatal Alcohol Exposure (PAE)

Adaptive Functioning, Social Skills, Mental Health, and Personal Strengths among Adolescents with Prenatal Alcohol Exposure (PAE)

FASD: folic acid and formic acid — an unholy alliance in the alcohol abusing mother

Interventions for Fetal Alcohol Spectrum Disorder: Meeting Needs Across the Lifespan

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