Psychiatric conditions associated with prenatal alcohol exposure

Abstract

Since the identification of fetal alcohol syndrome (FAS) over 35 years ago, mounting evidence about the impact of maternal alcohol consumption during pregnancy has prompted increased attention to the link between prenatal alcohol exposure (PAE) and a constellation of developmental disabilities that are characterized by physical, cognitive, and behavioral impairments. These disabilities include a continuum of developmental disorders known as fetal alcohol spectrum disorders (FASDs). Longitudinal studies suggest that individuals with FASDs are at a greatly increased risk for adverse long-term outcomes, including mental health problems and poor social adjustment. This review summarizes the existing literature on mental health outcomes for individuals with PAE across the lifespan, including findings in infancy and early childhood, middle childhood, and adolescence and early adulthood. Research on the psychiatric disabilities suffered by individuals with FASDs throughout development highlights the need for training of mental health professionals in the identification and the provision of specific treatments to address the unique features of this developmental disability since early identification and treatment have been demonstrated to be protective against more serious secondary disabilities. It is hoped that with greater awareness of the mental health problems experienced by individuals with FASDs, these individuals can receive appropriate and early treatment resulting in more adaptive and rewarding lives.

Misdiagnosis and Missed Diagnoses in Foster and Adopted Children With Prenatal Alcohol Exposure

“…3 Unfortunately, many children and adolescents with FASD go unrecognized and untreated [6][7][8] ; this is due to multiple factors, including unknown maternal history of alcohol use during pregnancy, 9,10 lack of consistent facial dysmorphology and growth impairment across all diagnoses within the fetal alcohol spectrum, 3,4,10,11 and the high rate of cooccurring mental health disorders. 12 Within our clinic's population at the Children's Research Triangle (CRT), it was noted that large numbers of children with FASD had been incorrectly diagnosed before referral. The purpose of this article is to assess the rate of misdiagnosis and missed diagnoses of FASD among a population of children and adolescents referred to a children's mental health center for assessment and treatment.…”

Mental Health Outcomes Associated with Prenatal Alcohol Exposure: Genetic and Environmental Factors

“…We found that early irritability and poor mother-child interactions in the more heavily exposed infants at 1 year of age predicted higher levels of depression at 6 years of age, particularly for girls [8]. These findings emerged even though the mothers had not been identified as high-risk drinkers and the children were functioning within the high average range of intelligence.…”

“…Longitudinal studies suggest that individuals with PAE are at an increased risk for adverse long-term outcomes, including mental health problems and poor social adjustment [8]. This review summarizes the current literature on the underlying mechanisms of PAE vulnerability, including epigenetic, genetic, and environmental risk factors that predispose individuals with PAE to psychiatric illness.…”

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

“…Fortunately, this appears to be changing, as research in the field of interventions is growing. O'Connor and Paley [77] recommended an exploration of how existing treatments may be adapted to suit the FASD population, ways to evaluate efficacy of multi-level approaches that attempt to respond to the broad range of issues present for those with FASD, and how to effectively translate research into practice.…”