Editorial

Abstract

It is my great pleasure to introduce to you the first issue of 2019 featuring the WFSBP guidelines on how to grade treatment evidence for clinical guideline development together with the WFSBP and IAWMH guidelines for the treatment of alcohol use disorders in pregnant women, along with original research on pregnancy and alcohol disorders. The WFSBP guidelines on how to grade treatment evidence for clinical guideline development review sources of data typically used in guideline development as well as available grading systems and methods for evaluating risks of bias in publications. The authors propose a revised method for grading evidence which allows guideline developers to follow a multi-step approach of defining levels of evidence, applying criteria for grading and grading of recommendations. These recommendations also provide a grading system that considers potential biases in sources of evidence. The WFSBP and IAWMH guidelines for the treatment of alcohol use disorders in pregnant women evaluate all available publications and extracted data from national and international guidelines with respect to strength of evidence for the efficacy and safety of each recommended medication. In conclusion, there is no safe level of alcohol use during pregnancy and abstinence is recommended, whereas low doses of benzodiazepines may be used to prevent alcohol withdrawal symptoms when high and chronic alcohol intake is stopped. Finally, it is recommended that pharmacological treatment for maintenance of abstinence should not be used and the newborn should be searched for foetal alcohol spectrum disorders. Gris and colleagues examined whether antiphospholipid antibodies are associated with positive screening for common mental disorders in women with previous pregnancy loss. The authors report that women with antiphospholipid syndrome (APS) more frequently had mood disorders and anxiety than women without APS. Waszkiewicz et al. investigate long-term changes of salivary exogylcosidases and their applicability as chronic alcohol-drinking and dependence markers. Exoglycosidase activities were measured in the saliva of healthy social drinking controls, alcohol-dependent nonsmokers and alcohol-dependent smokers in consecutive days of abstinence after chronic alcohol drinking. Authors found markers of chronic alcohol consumption, alcohol dependence and chronic alcohol consumption and dependence. Girard and associates assessed serum inflammatory molecules and markers of neuronal damage in alcohol-dependent subjects after withdrawal. Serum sampling from alcohol-dependent subjects admitted to hospital revealed that alcohol-dependent subjects present an inflammatory condition that is not dependent on alcohol consumption. In a brief report, Zai et al. conducted a genetic study of neuregulin 1 and receptor tyrosine-protein kinase erbB-4 in tardive dyskinesia (TD). The authors found a genotype to be associated with risk for TD occurrence and increased severity of the disorder. The study supports a role for the neuregulin signalling pathway in TD.