Substance use, comorbid psychiatric disorders and suicide attempts in adult FASD patients

Abstract

Purpose Fetal alcohol spectrum disorders (FASD) are a group of developmental disabilities related to prenatal alcohol exposure. FASD is a life-long lasting condition with various neurocognitive impairments and deficits in daily-life functioning. Research also indicates that FASD patients have an increased prevalence for substance use, substance related disorders and other psychiatric disorders. In Germany, data on adult FASD patients and their mental health are rare. The purpose of this paper is to describe substance use and comorbid psychiatric disorders (in addition to FASD) and suicide attempts in adult FASD patients. Design/methodology/approach The German version of the structured “Mini International Neuropsychiatric Interview (MINI)” was administered to a convenience sample of patients attending a specialized FASD diagnostic service at a German university hospital to assess psychiatric disorders. Current and lifetime substance use were examined using sections from the German version of the “European Addiction Severity Index (EUROP-ASI-R)” interview. Findings In total, 31 adults with FASD were included. Two patients were diagnosed with a substance related disorder, one for alcohol and one for cannabis. Nearly half of all patients fulfilled the diagnostic criteria for mild mental retardation, a further 16 per cent fulfilled the criteria for another current comorbid psychiatric disorder. In total, 26 per cent reported at least one suicide attempt. Originality/value Given that the body of research literature on FASD in adulthood is sparse, even a clinical sample of thirty individuals expands knowledge on mental health and substance use in the adult FASD population. The sample was comprehensively assessed using validated structured interviews on mental health, substance use and FASD.

Suicidality and Associated Factors Among Individuals Assessed for Fetal Alcohol Spectrum Disorder Across the Lifespan in Canada

“…26 , 27 However, this finding aligns with previously reported rates of suicidal ideation/attempts among individuals with PAE/FASD, ranging from 13% to 47.4%, depending on the sample and how suicidality was defined. 13 , 20 , 21 , 28 …”

“…18 Since then, there is growing evidence that suicidality is a serious concern for this population across the lifespan. 13 , 19 - 22 Canadian researchers recently reported suicide as a leading cause of death in a group of individuals with FASD. 22 Another group of individuals with FASD were reported to begin experiencing suicidality at a significantly younger age than those without FASD (21 vs. 33 years).…”

Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder

“…Compared to the general population, individuals with FASD are reported to be 10 times more likely to have ADHD, 20 times more likely to have substance use problems, and 25 times more likely to be diagnosed with a psychotic disorder ( Popova et al, 2016 ; Weyrauch et al, 2017 ). Challenges with substance use ( Dodge et al, 2019 ; Goldschmidt et al, 2019 ) and suicidality ( Dirks et al, 2019 ; O’Connor et al, 2019 ; Flannigan et al, 2021b ) are also common in this population.…”

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

“…Elevated rates of both internalizing and externalizing problems have been reported among people with FASD (Khoury et al, 2018), and common comorbid diagnoses include attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and psychotic disorders (Fryer et al, 2007;Lange et al, 2018;Pagnin et al, 2019;Patel et al, 2020;Popova et al, 2016;Rasmussen et al, 2010;Weyrauch et al, 2017). Individuals with FASD also experience high rates of suicidality (Landgren et al, 2019;O'Connor et al 2019;Streissguth et al, 1996), which has been linked to comorbid mental health and substance use problems, impaired emotion regulation, history of trauma, financial stress, and a lack of stable social support (Dirks et al, 2019;Huggins et al, 2008;Temple et al, 2019). PAE is also associated with the development and high rates of substance use problems later in life (Dodge et al, 2019;Goldschmidt et al, 2019;McLachlan et al, 2020;Streissguth et al, 1996Streissguth et al, , 2004Yates et al, 1998).…”