Raum:
Saal A7 (Stream/on Demand)
Topic:
Wissenschaftliches Programm
Topic 02: Psychische Störungen durch psychotrope Substanzen, Verhaltenssüchte, F1
Stream/on Demand
Format:
State-of-the-Art-Symposium
Dauer:
90 Minuten
Besonderheiten:
Q&A-Funktion
New insights into the neurobiological basis of alcohol problems have been gained in the field of social isolation stress, neuropsychology and the acute and chronic effects of alcohol on the brain. They establish a deeper understanding of the origin and course of the disease. The treatment approach consists of an individually designed combination of outpatient, day patient and inpatient measures, including medical consultations, “qualified withdrawal treatment”, pharmacological and psychotherapeutic relapse prevention and long-term inpatient rehabilitation treatment. Extensive S3 guidelines are available for the treatment approach. With current treatments, abstinence rates of 50% to 60% can be achieved in one year. However, several findings raise the question whether abstinence always has to be the only therapeutic goal. A reduction in alcohol use was previously described with behavioural therapy and can also be supported pharmacologically.
The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association has significantly changed the diagnoses of dependence disorders: it no longer uses the terms “addiction and abuse” or “harmful use” but encompasses both these terms in a dimensional approach under the new diagnosis “alcohol-related disorders”. ICD-11, on the other hand, will retain categories of harmful use and substance dependence, albeit with a regrouping of diagnostic criteria.
In sum, the above-mentioned advances emphasize the role of general practitioners and therapists in the treatment of substance use disorders. The symposium will present the diagnostic and neurobiological principles and describe practical aspects of the latest findings.
17:15 Uhr
Neurobiology of the development and maintenance of alcohol dependence – preventive and therapeutic starting points
A. Heinz (Berlin, DE)
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Autor:in:
A. Heinz (Berlin, DE)
Neurobiological correlates of the most important symptoms and diagnostic criteria of alcohol dependence have been identified and affect our treatment concepts. Genetic and neurobiological studies in animal models and humans indicate that a low sensitivity to the acute effects of alcohol is a key predictor of developing an alcohol use disorder. Chronic alcohol use is accompanied by a change in the balance between excitatory and inhibitory neurotransmitter systems, which contributes to the development of tolerance and triggers withdrawal symptoms when alcohol intake is suddenly discontinued. Animal models and studies in humans emphasize the role of the dopamine-innervated, so-called “reward system” in alcohol use disorders. Due to neuroadaptive processes, a relatively increased response to immediate, alcohol-associated reward is accompanied by a reduced activation elicited others, e.g. social reinforcers. Alterations in dopaminergic neurotransmission can also impair new learning processes and contribute to a somewhat reduced learning speed, which makes it more difficult for detoxified patients to learn alternative, non–addiction-related behaviours. Furthermore, alcohol-related changes can contribute to a largely “habitual” alcohol consumption, which can be targeted by behavioural therapy training programmes, personalized psychotherapy and some individually adjusted drugs.
18:00 Uhr
Evidence-based treatment of alcohol dependence
F. Kiefer (Mannheim, DE)
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Autor:in:
F. Kiefer (Mannheim, DE)
The psychiatric and psychotherapeutic care of patients with alcohol problems offers new opportunities. The prevalence figures of around 4 million affected people show that the need for consultation and treatment is extremely high and hardly met. The fact that at the same time the treatment options have expanded considerably in recent years means that the treatment of alcohol dependence is associated with great challenges and opportunities.
Therapeutic strategies for pharmacotherapy and psychotherapy can be derived from the neurobiological findings, together with relapse events and evidence-based treatment guidelines. Abstinence is still the therapeutic goal, but is being increasingly supplemented by the therapeutic goal of reducing the amount of drinking in different patient groups. This will be discussed in the light of the current care situation.
Psychotherapy is based in particular on “motivational interviewing”. This approach addresses the conflict of ambivalence that patients often have with the aim of changing behaviour. Psychotherapy methods such as stimulus exposure training or cognitive behavioural therapy have positive effects, at least in subgroups of patients.