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1、SeminarAlcohol-usedisordersMarcASchuckitLancet2009;373:492–501Alcoholdependenceandalcoholabuseorharmfulusecausesubstantialmorbidityandmortality.Alcohol-usePublishedOnlinedisordersareassociatedwithdepressiveepisodes,severeanxiety,insomnia,suicide,andabuseofotherdrugs.January26,2009Con
2、tinuedheavyalcoholusealsoshortenstheonsetofheartdisease,stroke,cancers,andlivercirrhosis,byaffectingDOI:10.1016/S0140-thecardiovascular,gastrointestinal,andimmunesystems.Heavydrinkingcanalsocausemildanterogradeamnesias,6736(09)60009-Xtemporarycognitivedeficits,sleepproblems,andperipher
3、alneuropathy;causegastrointestinalproblems;decreaseSeeEditorialpage433bonedensityandproductionofbloodcells;andcausefetalalcoholsyndrome.Alcohol-usedisorderscomplicateDepartmentofPsychiatry,assessmentandtreatmentofothermedicalandpsychiatricproblems.Standardcriteriaforalcoholdependence
4、—theUniversityofCalifornia,SanDiego,CA,USAmoreseveredisorder—canbeusedtoreliablyidentifypeopleforwhomdrinkingcausesmajorphysiological(MASchuckitMD);andVAconsequencesandpersistentimpairmentofqualityoflifeandabilitytofunction.CliniciansshouldroutinelyscreenSanDiegoHealthcareSystem,fora
5、lcoholdisorders,usingclinicalinterviews,questionnaires,bloodtests,oracombinationofthesemethods.CausesSanDiego,CA,USAincludeenvironmentalfactorsandspecificgenesthataffecttheriskofalcohol-usedisorders,includinggenesfor(MASchuckit)enzymesthatmetabolisealcohol,suchasalcoholdehydrogenaseand
6、aldehydedehydrogenase;thoseassociatedwithCorrespondenceto:DrMarcASchuckit,VASanDiegodisinhibition;andthosethatconferalowsensitivitytoalcohol.TreatmentcanincludemotivationalinterviewingtoHealthcareSystem,3350LaJollahelppeopletoevaluatetheirsituations,briefinterventionstofacilitatemore
7、healthybehaviours,detoxificationtoVillageDrive,SanDiego,addresswithdrawalsymptoms,cognitive-behaviouraltherapiestoavoidrelapses,andjudicioususeofdrugstoCA92161-2002,USAdiminishcravingsordiscouragerelapses.mschuckit@ucsd.eduIntroductionproportionofthehealth-careburdeninalmostallThealco
8、hol-usedisor
