Beruflich Dokumente
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SEPTEMBER 2004
The symptoms
Children with severe fetal alcohol syndrome have a characteristic look. They are
short and thin, with small heads and distinctive facial features, which may include
drooping eyelids, a short upturned nose
with a low bridge, a thin upper lip, a bulging
forehead, and a receding chin. Some also
have heart, kidney, or urinary tract defects,
poor muscle tone or joint articulation, and
other physical disabilities.
But in most cases, their emotional and
intellectual limitations are more serious.
Many are mildly retarded; the average IQ is
about 70, putting them in the lowest 2.5%
of the population. But even those with normal intelligence suffer impaired learning,
memory, judgment, and impulse control.
They may be hyperactive and distractible,
and they have difficulty appreciating the
consequences of their actions or behaving
INSIDE
Depression and pain
They go together and must
often be treated together. . . . . . 4
In brief:
Missing mental health services:
Worldwide, the most serious
problems often go without
treatment. . . . . . . . . . . . . . . . . . 6
Smoking and schizophrenia:
Why are people with schizophrenia addicted to nicotine? . . . . . 6
Omitting medications in
schizophrenia: The costs and
consequences of following or
ignoring doctors orders. . . . . . 7
Improving patient communication: A checklist helps schizophrenic patients say what they
need. . . . . . . . . . . . . . . . . . . . . . 7
Q&A:
What is a therapeutic alliance,
and why is it important? . . . . . .8
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Published by Harvard Health Publications,
a division of Harvard Medical School
Editor in Chief Anthony L. Komaroff, MD
Publishing Director Edward Coburn
2004 President and Fellows of Harvard College. (ISSN 08843783)
Proceeds support the research efforts of Harvard Medical School.
Biological mechanisms
Alcohol is what pharmacologists call
a dirty drug, meaning that it acts by
many different mechanisms to produce many different effects. When it
circulates in the bloodstream of a
fetus, it interferes with development
at many points. Heavy drinking can
reduce the amount of food and oxygen carried to the fetus and increase
levels of damaging oxygen free radicals. It upsets the regulation of cell
growth, causing premature cell death,
preventing the generation of new
cells, and altering the structure and
placement of existing ones. In brain
cells, it can prevent the generation of
synapses and the protective cover of
myelin and interfere with the action
of neurotransmitters.
Resources
National Organization on Fetal
Alcohol Syndrome
www.nofas.org
800-66NOFAS
Substance Abuse and Mental
Health Services Administration, Fetal Alcohol Spectrum
Disorders Center for
Excellence
www.fascenter.samhsa.gov
866-STOPFAS (786-7327)
Information about prevention
studies is available from the
Computer Retrieval Information
on Scientific Projects database.
crisp.cit.nih.gov
www.health.harvard.edu
Prevention
The general population is now informed of these risks through public
service announcements, brochures in
doctors offices and clinics, and the
warning labels on alcoholic beverage
SEPTEMBER 2004
SEPTEMBER 2004
www.health.harvard.edu
References
Hankin JR. Fetal Alcohol Syndrome
Prevention Research, National Institute
on Alcohol Abuse and Alcoholism
Publications, August 2002.
www.niaaa.nih.gov
Jacobson JL, et al. Drinking
Moderately and Pregnancy: Effects on
Child Development, Alcohol Research
and Health (1999): Vol. 23, No.1,
pp. 2530.
National Institute on Alcoholism and
Alcohol Abuse. Tenth Special Report
to the United States Congress on