Multidisciplinary View of Alcohol Use Disorder: From a Psychiatric Illness to a Major Liver Disease

Abstract

Alcohol use disorder is a significant health problem being a cause of increased morbidity and mortality worldwide. Alcohol-related illness has a relevant economic impact on the society and a negative influence on the life of patients and their family members. Psychosocial support might be useful in the management of people affected by alcohol use disorder since psychiatric and pharmaceutical approaches show some limits. In fact, many drugs are accessible for the treatment of alcohol disorder, but only Baclofen is functional as an anti-craving drug in patients with advanced liver disease. The alcohol-related liver damage represents the most frequent cause of advanced liver disease in Europe, and it is the main cause of death among adults with high alcohol consumption. The multidisciplinary action of clinical-psychologists, psychiatrics and hepatologists, is essential in the management of patients with alcohol liver disease especially in the case of liver transplantation. In general, the multidisciplinary approach is necessary in prevention, in framing patients and in the treatment. More resources should be used in prevention and research with the main aim of decreasing the harmful alcohol consumption.

Decreased plasma concentrations of BDNF and IGF-1 in abstinent patients with alcohol use disorders

“…Chronic alcohol consumption can affect neurons and glial cells in the central nervous system (CNS), producing profound changes in synaptic structure and function. In fact, the toxic effects of alcohol exposure during early development may result in long-lasting behavioral and neurocognitive changes [ 2 ]; and excessive alcohol exposure during adulthood may lead to a chronic relapsing brain disease that receives the medical diagnosis of alcohol use disorder (AUD) [ 3 ]. Currently, AUD is a single disorder that integrates both alcohol abuse and alcohol dependence and is characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state emerging in conjunction with withdrawal and protracted abstinence [ 3 – 4 ].…”

“…In fact, the toxic effects of alcohol exposure during early development may result in long-lasting behavioral and neurocognitive changes [ 2 ]; and excessive alcohol exposure during adulthood may lead to a chronic relapsing brain disease that receives the medical diagnosis of alcohol use disorder (AUD) [ 3 ]. Currently, AUD is a single disorder that integrates both alcohol abuse and alcohol dependence and is characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state emerging in conjunction with withdrawal and protracted abstinence [ 3 – 4 ]. AUD is commonly associated with cognitive and memory impairment during development with a higher incidence of comorbid mental disorders, particularly depression and anxiety [ 5 ], and other organic comorbid diseases (e.g., alcohol liver diseases) [ 3 , 6 ].…”

Analysis of the Association of Nonsynonymous Polymorphisms in ADH Genes with Hazardous Drinking in HIV‐1‐Positive Individuals

“…HD is also associated with risky behaviors, low treatment adherence, and rapid progression to AIDS (Armstrong et al., ). HD pattern of alcohol consumption has obvious consequences in the immune system (Pandrea et al., ), liver (Gitto et al., ; Ioannou et al., ), and brain cells (Gitto et al., ; Heinz et al., ). Alcohol use disorder was associated with advanced hepatic fibrosis among HIV‐1‐monoinfected patients (not influenced by hepatitis B and C coinfection) in a previous cross‐sectional study (Kim et al., ).…”

Multi-Organ Alcohol-Related Damage: Mechanisms and Treatment

“…An article by Deshpande et al [ 17 ] highlights previously unknown effects of moderate ethanol exposure on hepatic wound healing after acute carbon tetrachloride exposure by indicating that moderate ethanol affected each phase of the wound healing response to this hepatotoxicant. Finally, the review article by Gitto et al [ 18 ] discusses the usefulness of psychosocial support in the management of people affected by alcohol. These authors reflect that a multidisciplinary approach involving clinical-psychologists, psychiatrics and hepatologists should be considered as essential in the management of patients with alcohol liver disease especially in the case of liver transplantation.…”

“…The list of articles published in Special Issue “Multi-Organ Alcohol-Related Damage: Mechanisms and Treatment” is presented in Refs. [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”