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Alcohol use disorder

Última revisão: 18 Jun 2025
Última atualização: 18 Sep 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • withdrawal
  • tolerance
  • increased/decreased liver size, jaundice, ascites
Detalhes completos

Outros fatores diagnósticos

  • insomnia
  • erectile dysfunction
  • nicotine use disorder
  • gastrointestinal distress
  • muscle cramps, pain, tenderness, altered sensory perception
  • hypertension and tachycardia
  • impaired nutritional status
  • broad-based gait
Detalhes completos

Fatores de risco

  • family history of alcohol use disorder
  • antisocial behavior (premorbid)
  • high trait anxiety level
  • lack of facial flushing on exposure to alcohol
  • low responsivity to the effects of alcohol
  • history of gastric bypass
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • diagnostic interview
  • alcohol level (breath and blood)
  • Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)
Detalhes completos

Investigações a serem consideradas

  • carbohydrate-deficient transferrin (CDT)
  • gamma glutamyl transpeptidase (gamma-GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST)
  • CBC
  • urinary ethyl glucuronide
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

at-risk drinking

alcohol use disorder: nonpregnant adult with no concurrent opioid use or mental health diagnosis

alcohol use disorder: nonpregnant adult with concurrent opioid use

alcohol use disorder: nonpregnant adult with concurrent mental health diagnosis

alcohol use disorder: nonpregnant adolescent

alcohol use disorder: pregnant

Colaboradores

Autores

Elisabeth Poorman, MD, MPH

Assistant Professor of Medicine

Department of Medicine

University of Illinois Chicago

Chicago

IL

Declarações

EP declares that she has no conflicting interests.

Marlene Martin, MD

Associate Professor of Clinical Medicine

Director, Addiction Care Team

San Francisco General Hospital

University of California, San Francisco

San Francisco

CA

Declarações

MM is a board member for the National Harm Reduction Coalition and has done consultancy work for the Society of Hospital Medicine.

Sarah Messmer, MD

Assistant Professor of Clinical Medicine and Pediatrics

University of Illinois Chicago

Chicago

IL

Declarações

SM declares that she has no conflicting interests.

Agradecimentos

Dr Elisabeth Poorman, Dr Marlene Martin, and Dr Sarah Messmer would like to gratefully acknowledge Dr Colin Drummond, Dr Julie R. Pittman, Dr Philip H. Chung, Dr Robert M. Swift, and Dr Lorenzo Leggio, previous contributors to this topic.

Declarações

CD, JRP, PHC, and RMS declare that they have no competing interests. LL is an author of a reference cited in this topic.

Revisores

Paul S. Haber, MD

Royal Prince Alfred Hospital and Discipline of Medicine

University of Sydney

Sydney

Australia

Declarações

PSH is an author of a reference cited in this topic.

Roberta Agabio, MD

Bernard B. Brodie Department of Neuroscience

University of Cagliari

Cagliari

Italy

Declarações

RA is an author of a number of references cited in this topic.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90.Texto completo  Resumo

Lingford-Hughes AR, Welch S, Peter L, et al. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction, and comorbidity: recommendations from BAP. J Psychopharmacol. 2012 Jul;26(7):899-952. Resumo

Anton RF, O'Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006 May 3;295(17):2003-17.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Other psychiatric disorders
    • Other substance use disorders (especially sedatives)
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR)
    • International statistical classification of diseases and related health problems, 11th ed. (ICD-11)
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Alcohol-use disorder

    Mais Folhetos informativos para os pacientes
  • Calculadoras

    Alcohol Consumption Screening AUDIT Questionnaire

    Mais Calculadoras
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