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The Royal College of Psychiatrists Improving the lives of people with mental illness

CR185. Alcohol and Brain Damage in Adults: With reference to high-risk groups

Price: £0.00

Approved: Sep 2013

Published: May 2014

Status: current

Number of pages: 90

Review by: 2018

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This report calls for clinical commissioning groups to support services that provide specialist care for patients with alcohol-related brain damage (ARBD). It highlights how alcohol abuse can cause changes to people’s brain function and intellect, even though many will not be aware of it. However, carers, relatives and others may notice this and it can jeopardise work, family relationships and cause domestic and financial problems. It has been published in association with the Royal College of Physicians (London), the Royal College of General Practitioners and the Association of British Neurologists.


The report reviews the literature relating to the definition, epidemiology, information on the neurobiological changes associated with ARBD and implications for medical treatments, service organisation and provision, assessment, and psychosocial interventions. The expert panel has reviewed the evidence and derived recommendations for commissioners and service providers.


Specific recommendations are presented in the context of four specialist settings: alcohol treatment services, prisons, acute hospitals and pregnancy/fetal alcohol spectrum disorder (FASD).


The report provides examples of service delivery models couched in the context of a team within a mental health trust, accessing clinicians across clinical teams, an ARBD team closely affiliated with the alcohol treatment services and a team embedded within an early onset dementia team. In the absence of significant research (except in a minority of areas), the evidence is derived from descriptive studies and clinical reviews.


This guideline represents the best evidence available and it provides a source document for both commissioners and service providers in the assessment and management of this stigmatised and neglected group of patients.


  • List of abbreviations
  • Working group
  • Executive summary and recommendations
  • Lay summary
  • Introduction
  • Clinical definition and diagnosis of alcohol-related brain damage and related syndromes
  • Epidemiology of alcohol-related brain damage and related syndromes
  • Neurobiological basis of Wernicke–Korsakoff syndrome and alcohol-related brain damage
  • Clinical management
  • Psychosocial and cognitive rehabilitation of severe alcohol-related brain damage
  • Legal framework
  • High-risk populations: patients presenting to alcohol treatment services
  • Screening and management of alcohol-related brain damage within the prison service
  • Screening and care in acute hospital-based medical and surgical settings
  • Pregnancy and fetal alcohol spectrum disorder
  • Examples of service provision
  • Appendix: Alcohol-related brain damage patient and public information leaflet
  • References
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