Fetal alcohol spectrum disorders and mental illness

Objective: To discuss relevant issues in the diagnosis of mental disorders comorbid with fetal alcohol spectrum disorders (FASD). Methods: We present a theoretical model of the effect of prenatal alcohol exposure on neurobehavioral development and a systematic review of published data on the mental disorders in subjects with an FASD. Results: Prenatal alcohol exposure is associated with high rates of mental disorders. We found 48 papers reporting on 3,343 subjects. The most common mental disorder comorbid with FASD is attention deficit - hyperactivity disorder occurring in 48% of subjects with FASD. Cognitive impairment is also very common. Discussion: Prenatal alcohol exposure appears to have differential effects on outcomes leading to large increases in rates of some but apparently not most mental disorders. We discuss strategies to improve the diagnosis of mental disorders in FASD and the multiplicity of uses for this important data.