Fichier: 

Focus n10.pdf

Couverture: 

For psychiatrists, who are the first involved in the management of alcoholic patients, the NESARC is a major event. It calls into question some hitherto widely accepted tenets. This is why Professor Gorwood (psychiatrist and member of the IREB Scientific Committee) intended to interview Professor Adès, psychiatrist and head of department at the Louis Mourier University Hospital Centre in Colombes (92), about this survey.
For the uninformed reader, it is important to remember that this survey involved notions which are sometimes complex but correspond to tangible elements. Thus “abuse” and “dependence”, when related to a substance, should not be given their normal meaning. In psychiatry, these notions refer to precise criteria classifying subjects into the appropriate category. Use of these criteria is nonetheless crucial, insofar as there is no biological test to tell us whether a subject suffers from substance abuse or dependence.
NESARC was a survey conducted on a sample from the general population of the United States of America. It was not performed in alcoholic patients, so the results may sometimes appear surprising.
The survey highlighted two important points:
- one can be dependent on a substance (particularly alcohol) without necessarily abusing
this substance;
- mood or anxiety disorders may persist, even after withdrawal, suggesting that the causal
relationship between consumption of a substance and mental disorders is not systematic.
Interesting in many respects, it also raises the problem of defining a threshold above which a subject can be considered as “suffering from a disease”…

NESARC main results (National Epidemiologic Survey on Alcohol and Related Conditions, USA)
Including an interview with:
Professor Jean Adès, Head of the Adult Psychiatry Department, Louis Mourier University Hospital Centre (Colombes)
by Professor Philip Gorwood, psychiatrist at the Louis Mourier University Hospital Centre, (Colombes)
and member of the IREB Scientific Committee