Substance use, comorbid psychiatric disorders and suicide attempts in adult FASD patients
Background: 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 the study is to describe substance use and comorbid psychiatric disorders and suicide attempts in adult FASD patients.
Methods: 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.
Results: Preliminary results are presented, data collection is still in progress. Up to now, 37 adults with FASD were included. 55 % drank alcohol, 13 % smoked cannabis and 7 % used amphetamines in the previous 30 days. Three patients were diagnosed with a substance related disorder, one for alcohol, one for cannabis and one for stimulants. Nearly half (48 %) of all patients fulfilled the diagnostic criteria for mild mental retardation, a further 16 % fulfilled the criteria for another current comorbid psychiatric disorder. In total, 28 % reported at least one suicide attempt.
Conclusion: Compared to the German general population in the same age range, current alcohol use was lower among FASD patients, but higher for cannabis and stimulant use. Comorbid mental disorders (excl. mental retardation) and substance related disorders were considerably lower in our sample than in previous research. Although prevalence was lower than in previous research, a relevant number of FASD patients are affected by a comorbid mental health disorder. Alcohol and drug use, especially cannabis, should be considered in FASD care settings. Striking is the high number of suicide attempts. Adult FASD patient seem to be a very vulnerable group for suicide attempts. It seems to be important to create awareness about the high risk of suicidality among patients in FASD care settings. Professionals working with FASD patients should keep high rates of suicide attempts in mind and discuss suicide ideation with their patients. Planning individual therapeutic interventions, mental retardation and learning deficits of many FASD patients must be kept in mind.