People With Fetal Alcohol Syndrome Suffer All Their Lives
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Famy, C., Streissguth, A.P., and Unis, A.s. (1998) Mental illness in
adults with fetal alcohol syndrome or fetal alcohol effects American
Journal of Psychiatry, 155, 552-554.
Overview:
Fetal Alcohol Syndrome
Prenatal exposure to alcohol can be associated with a wide range of abnormalities.
Children with fetal alcohol syndrome (FAS) may have physical abnormalities,
such as microcephaly (abnormally small head), eye and ear abnormalities,
heart defects, and poor motor coordination. They also have psychological
impairments, such as mild to moderate mental retardation, attention deficit
disorder with hyperactivity, and conduct disorders. Some children do not
manifest physical abnormalities but still have intellectual difficulties,
attention deficit disorder with hyperactivity, motor coordination problems,
and conduct disorders. These children are classified as having fetal alcohol
effects (FAE).
FAS/FAE is one of the most preventable causes of mental retardation.
A large amount of research has established that there is no safe amount
of alcohol consumption during pregnancy. Pregnant women are constantly
warned - by physicians, through advertising, and on warning labels - not
to drink during pregnancy. Even so, FAS/FAE is one of the leading causes
of mental retardation in North America.
Educational programs have been developed to deal with the special problems
that children with FAS/FAE experience while growing up. What about adults
with FAS/FAE? Very little research has been done to identify long term
effects of FAS/FAE. Famy, Streissguth, and Unis (1998) examined psychological
problems in adults with FAS/FAE as part of a longitudinal study of the
effects of prenatal exposure to alcohol.
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Instructors | For Students
Article Summary
Individuals with behavior control difficulties as children have a strong
tendency to develop psychiatric problems as adults. Do children with FAS/FAE,
developmental disorders characterized by behavioral problems, such as attention
deficit with hyperactivity, impulsivity, and conduct disorders, have a
high rate of psychiatric problems? Famy, Streissguth, and Unis (1998) addressed
this question.
They conducted structured interviews of individuals involved in a longitudinal
study of FAS/FAE to determine the degree and nature of psychiatric problems
experienced by adults with FAS/FAE. The structured interviews were used
to diagnose Axis I (Clinical Syndromes) and Axis II (Personality Disorders)
as laid out in the Diagnostic and Statistical Manual of Mental Disorders,
3rd edition-revised and 4th edition (DSM-III and DSM-IV). Axis I diagnoses
are more severe and debilitating disorders, such as substance-related disorders,
anxiety disorders, mood disorders, and psychotic disorders. Axis II diagnoses
are less severe personality disturbances, such as avoidant personality
disorder, antisocial personality disorder, and dependent personality disorder.
Recent epidemiological studies have determined that approximately one-third
of the population has experienced a psychological disorder. Famy et al,
diagnosed 92% of their sample with an Axis I disorder and 48% with an Axis
II disorder. Many people received multiple diagnoses.
The most common Axis I diagnosis was a substance-related disorder (60%).
Major depression and psychotic disorders were next most common (44% and
40%, respectively). Anxiety disorders and eating disorders were also common
(20% each). With the exception of anxiety disorders, these diagnoses are
two to four times greater than found in the general population. These disorders
were approximately equally distributed across gender and across FAS/FAE
diagnosis.
Though potentially less personally debilitating, Axis II diagnoses were
also quite high. The most common diagnoses were avoidant personality disorder
(29%), antisocial personality disorder (19%), and dependent personality
disorder (14%).
According to their self-reports, over 70% of the sample had received
some form of psychiatric treatment, and one-third of these people had been
hospitalized.
Famy et al.'s results indicate that adults with FAS/FAE have a very
high rate of mental illness. Although the sample size was somewhat small,
there is no indication that this group was particularly extreme. This study
extends the debilitating effect of prenatal alcohol exposure on development
into adulthood. The fact that FAS/FAE can be prevented makes these findings
all the more upsetting.
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For Instructors
Links to the Lecture
There are a number of excellent videos on prenatal drug and alcohol exposure
and FAS/FAE:
Sacred Trust; Protect Your Baby Against Fetal Alcohol Syndrome (1992,
USDA, 14 min.). This video addresses Fetal Alcohol Syndrome (FAS) and Fetal
Alcohol Effects (FAE) among Native American women.
The Mind: Fetal Alcohol Syndrome (1988, PBS, 5 min.).
Overview | Article Summary
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For Students
About the Authors
Chris Famy is a student in the University of Washington School of Medicine.
Ann
Streissguth and Alan
Unis are professors in Department of Psychiatry and Behavioral Sciences
at the University of Washington School of Medicine. Dr. Streissguth directs
the Fetal
Alcohol and Drug Unit which conducts longitudinal studies of children
with FAS/FAE and families with alcohol and drug abuse.
About the Journal
The American Journal of Psychiatry
publishes a wide range of articles reporting experimental research, case
studies, and reviews dealing with psychiatric medicine and clinical research.
Links to Life
Lean more about FAS/FAE
-
The League For The Prevention of Alcohol Related Fetal Brain Injury provides
a wealth of on-line information
and links related to FAS.
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This policy statement
on FAS/FAE from the American Association of Pediatrics includes information
about symptoms, treatment, and prevention.
-
Read these cogent arguments
against alcohol use during pregnancy written by medical school professors.
Are you Alcohol Dependent or an Alcohol Abuser?
Each of these scales provides information about how to get help for a dependence
or abuse problem:
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