home Auditorium 7 Psychosis after binge drinking. More about alcohol: delirium, pseudoparalysis and epilepsy. Treatment of alcoholic psychosis

Psychosis after binge drinking. More about alcohol: delirium, pseudoparalysis and epilepsy. Treatment of alcoholic psychosis

This refers to mental disorders, one of the causes of which is chronic alcohol intoxication. There are acute alcoholic psychoses and alcoholic encephalopathies.

Acute alcoholic psychoses

1. Delirium. Accounts for 75% or more of all alcoholic psychoses. Develops after five years chronic alcoholism, most often between the ages of 40 and 50 years. Psychosis usually begins 2–4 days after the end of the binge against the background of severe withdrawal symptoms. Typical manifestations of alcoholic delirium are: a) disorientation in place, time and environment, orientation in one’s own personality is not disturbed; b) deceptions of perception, more often visual illusions and hallucinations; c) figurative and emotionally charged delusional ideas (persecution, jealousy, etc.); d) affective disorders with fear, bewilderment and humor; e) motor agitation with fussiness; e) pronounced somatovegetative and neurological disorders(tremor, ataxia, low-grade fever and etc.); partial congrade amnesia, hallucinatory experiences are better remembered.

Psychosis lasts 3–6 days, intensifying at night. 5% of patients have epileptic seizures. The main types of delirium are hypnagogic, abortive, systematized, delirium without delirium and delirium with severe verbal hallucinations. There are also atypical forms of delirium: delirium with a fantastic content of perceptual deceptions, delirium with oneiric disorders (with stupor and visual pseudohallucinations), delirium with mental automatisms, prolonged delirium, professional and muttering (mussing) types of delirium. Severe forms of delirium are accompanied by stunned consciousness, hyperthermia, massive somatoneurological disorders and, in almost half of the cases, epileptic seizures.

2. Hallucinosis. They account for 5 to 28% of all alcoholic psychoses in patients aged 40–43 years (on average). More often they occur 7–8 years after the onset of alcoholism. There are acute, protracted and chronic versions of psychosis.

Acute hallucinosis occurs at the end or at the end of binge drinking. Against the background of anxiety, suspicion, somatovegetative disorders in men, and in women - and depression, with a formally unchanged consciousness, verbal hallucinations of various content, including “alcoholic” ones, arise. There may be delirious inclusions, especially at night. There is no criticism of the voices; usually a hallucinatory delusion of persecutory content develops. Psychosis lasts up to one month, before its end a critical attitude towards hearing deceptions appears. Cases of hallucinosis with oneiric stupefaction, severe depression, as well as mental automatisms are defined as atypical variants of alcoholic hallucinosis. Protracted hallucinosis with a disease duration of one to six months has also been described. In this case, there may be states with a predominance of persecutory delusions or severe depression.

Chronic hallucinosis occurs in 4.3–9% of all cases of hallucinosis. They last for more than a year, sometimes tens of years. Some patients have a history of delirious psychoses, acute hallucinosis, delirious-hallucinatory psychoses, the most common is chronic verbal hallucinosis without hallucinatory delusions, less often - a less favorable variant of hallucinosis with delusions. Over time, a psychoorganic decline occurs. Cases of chronic hallucinosis with phenomena of mental automatism and paraphrenization of delirium are relatively rare. Unlike schizophrenia, in hallucinosis with schizophrenia-like symptoms, deficit symptoms of schizophrenia do not develop.

3. Delusional psychoses occur in alcoholism with a frequency of 1 to 9.5%, more often in men. Alcoholic paranoid and alcoholic delirium jealousy.

Alcohol paranoid develops suddenly during binge drinking or during abstinence. This is a delusion of perception or figurative delusion with a persecutory nature, with anxiety, fear and delusional behavior. There may be illusions, isolated hallucinations. Delirious symptoms and verbal hallucinations sometimes occur in the evening and at night. Lasts up to several weeks. Abortion paranoids continue throughout the day. Protracted paranoids occur with a predominance of depression and anxiety, delusions tend to be systematized and persist for months.

Alcoholic delusions of jealousy occur in individuals with a paranoid character. Ideas of jealousy are expressed sporadically at first and only in intoxication or withdrawal symptoms. The growing alienation of the spouses contributes to the consolidation and further development of delirium, which over time becomes systematized and divorced from real reasons. Further, it may be joined by delusional ideas of persecution, poisoning, etc., thematically related to painful jealousy. Sometimes delusions of jealousy originate in acute alcoholic psychoses and later persist as residual delusions. There are patients who for a long time do not show their delirium either in behavior or in statements and then, as if suddenly, commit a carefully prepared murder.

Acute alcoholic psychoses may recur if patients continue to drink. As psychotic states are repeated, their picture is gradually reduced and relatively rarely becomes more complicated, the latter being more typical of atypical psychoses. Delirium, for example, gives way to hallucinosis, then oneiric psychosis follows, then depression, mental automatisms, figurative delirium and, finally, paraphrenic delirium.

Acute alcoholic psychoses can occur in old and senile age. Occurring against the background of a significant psychoorganic decline, they acquire a complex or atypical character. In delirium, for example, there are visual hallucinations that are fantastic or, on the contrary, ordinary in content; excitement occurs with a predominance of professional actions, often residual delirium remains after psychosis. With hallucinosis there may be deceptions of hearing with an everyday-damaging theme, and with paranoids - confabulations. Paraphrenization of delirium is observed much more often, psychoses are longer lasting.

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Alcoholic encephalopathy

Occurs mainly in the third stage of alcoholism. Mental disorders in encephalopathies are invariably combined with systemic somatic and neurological disorders, and the latter may predominate in the picture of the disease. The study of encephalopathies was started by S.S. Korsakov in 1887. He was the first to point out the role of vitamin B1 deficiency in the pathogenesis of encephalopathies. There are acute and chronic encephalopathies in alcoholism. About half of the patients had experienced delirium in the past. The manifestation of the disease is preceded by a prodromal period, sometimes lasting up to one year and often beginning in the spring and early summer. During this period, asthenia, adynamia, anorexia, weight loss, inversion of the sleep formula are observed, paresthesia and convulsions occur in the calf muscles, as well as in the fingers and toes. Ataxia, intention tremor, dizziness develop, and vision often deteriorates.

1. Acute encephalopathies. Gaye-Wernicke encephalopathy is observed mainly in men aged 30–50 years, occasionally in younger and older men. It begins with delirium, the peculiarity of which is that, against a background of anxiety, scanty, monotonous and static optical illusions and illusions. Monotonous motor excitement is represented mainly by everyday or professional actions, speech - by shouting individual words, muttering.

At times, patients are immobilized or mutated. Speech contact with them is interrupted. Amentia-like muttering is then replaced by somnolence, stupor, and in the most severe cases, coma. Various and changing neurological disorders are expressed: fibrillary muscle twitching, hyperkinesis, phenomena muscular dystonia, symptoms of oral automatism, ataxia, horizontal nystagmus, pupillary disorders (in the form of Gudden's symptom). There may be paresis, pyramidal signs, and stiffness of the neck muscles. The pressure of the cerebrospinal fluid is increased, as is the protein content in it, the cytosis is normal. Hyperthermia in severe cases reaches 40–41°C. There may be trophic disorders, dryness and hyperhidrosis of the skin, swelling of the extremities, decreased blood pressure, and increased breathing. In the blood - leukocytosis, the liver is enlarged, stools are loose and frequent.

3–10 days after the onset of the disease, “bright gaps” may occur, followed by repeated deterioration of the condition. Death often occurs in the second week of psychosis and is often caused by intercurrent illnesses. Possible recovery can be indicated by normalization of sleep, and in women, the appearance of confabulations. The outcome of the disease is psychoorganic decline, Korsakov's syndrome (more often in women) and symptoms of pseudoparalysis (more often in men).

Mitigated acute Korsakov encephalopathy with hypersthenic phenomena, dyspepsia and neuritis is initially replaced by mild nocturnal delirium, and during the day - drowsiness, depression, and hypochondriasis. Memory impairments are detected. Psychosis lasts up to 2–3 months; memory impairment disappears later than others.

Encephalopathy “with a hyperacute course” also occurs. It manifests itself as severe delirium, followed by severe stunned consciousness (to the point of coma), and hyperthermia up to 41°C. Death occurs on the 3rd–6th day of illness. At adequate treatment recovery with the development of a transient or prolonged pseudoparalytic syndrome is possible.

2. Chronic encephalopathies. Most often, this is Korsakoff's psychosis, usually developing in patients aged 40–50 years immediately following severe delirium or Gaiet-Wernicke encephalopathy. Much less often and mostly in older people it begins gradually. Mental disorders are represented by fixation and retrograde forms of amnesia, amnestic disorientation and confabulations. Confabulations are mundane and vicarious. Elderly patients are mostly lethargic, lethargic, sometimes irritable or hypochondriac. Younger patients are usually livelier, more active, and their mood may have a tinge of euphoria. As a rule, patients are aware of the fact of amnesia. Neuritis of the extremities with loss of sensitivity, muscle atrophy, disorders tendon reflexes. The disease generally progresses in a regressive manner, with neurological symptoms passing faster than mental ones. In young and middle-aged patients, as well as in women, significant improvements are possible without a pronounced psychoorganic decline.

Rarely, mainly in mature and late age, gradually or after severe delirium and acute encephalopathies, alcoholic pseudoparalysis develops. Patients are euphopic, disinhibited, rude, cynical and overestimate their capabilities, even to the point of having ideas of greatness. There are anxiety-agitated depressions with elements of Cotard's delirium. A significant decrease in mnestic-intellectual functions is revealed. Often there are trainers of the fingers, tongue, dysarthria, Gudden's symptom, neuritis, and other neurological symptoms. With a gradual onset, the disease becomes progressive.

A number of rare alcoholic encephalopathies have been described. Encephalopathy with Adams-Victor beriberi pattern occurs as a result of vitamin B1 deficiency. The phenomena of polyneuritis predominate, mainly lower limbs with impaired sensitivity or muscle strength. Psychopathology is represented primarily by the phenomena of asteria. Alcoholic pellagra is associated with a lack of vitamin PP. This disease is characterized by the appearance of symmetrical red or gray-brown areas of inflammation on the skin of the hands, and later peeling. Gastroenteritis is common. Phenomena of asthenia and shallow changes in memory (hypomnesia) are also observed. Encephalopathy with ambiosis is manifested by a violation of central or central-marginal vision, mostly for objects of red or white color.

In the fundus, slight blanching of the temporal part of the nipples is found optic nerve. Numerous neurological symptoms are combined with various manifestations asthenia. Encephalopathy from superior vena cava stenosis has been described in alcoholics with often unrecognized liver cirrhosis. Different degrees of deafening of consciousness are revealed; if stunning increases during the coma period, death may occur.

Alcoholic cerebellar atrophy is manifested by symptoms of cerebellar damage and psychoorganic decline varying degrees. Marchiafava-Bignami syndrome occurs due to central degeneration of the corpus callosum and occurs predominantly in men. The disease develops gradually, debuting with delirium. Then neurological disorders, close to those of Gaiet-Wernicke encephalopathy, appear and rapidly increase. Circle mental disorders includes symptoms of pseudoparalysis, fixation amnesia, confabulation, or severe delirium with stunned consciousness. In a coma or in a state of insanity, patients may die in the first 2–3 months after the onset of the disease. Central necrosis of the bridge is manifested by a state such as apathetic stupor. Finally, laminar cortical sclerosis is manifested by the symptom complex of alcoholic pseudoparalysis. The nosological independence of these diseases remains controversial.

When treating delirium tremens, the main measures are aimed at normalizing the somatic condition. First of all, this is detoxification using polyvidone, dextran-70, dextran-40, Trisol and Chlosol preparations, isotonic sodium chloride solution, Ringer's solution or 5% glucose solution intravenously, 500–1000 ml per day; Magnesium sulfate, sodium sulfate, calcium chloride are also administered intravenously, and unithiol is administered intramuscularly. Non-drug detoxification methods are also used: cleansing enema, plasmapheresis, hyperbaric oxygen therapy, superficial cerebral hypothermia, enterosorbents.

It is necessary to use vitamins: thiamine, pyridoxine, cyanocobalamin, ascorbic and nicotinic acids intravenously or intramuscularly. It is necessary to prescribe diuretics: mannitol intravenously, furosemide intramuscularly, acetazolamide or triampur orally. To eliminate psychomotor agitation and insomnia, sodium hydroxybutyrate, IV sodium thiopental, IM or IV seduxen are more preferable. Parenteral use of nootropics, as well as glucocorticoids (prednisolone, hydrocortisone) is very important. It is advisable to prescribe carbamazepine or depakine orally. In cases of respiratory failure and arrest, 10 ml of a 0.5% solution of bemegride is administered intravenously, and to eliminate laryngospasm and hypersalivation, 1 ml of a 1% solution of atropine sulfate is administered subcutaneously.

Of the neuroleptics, intramuscular or intravenous administration of a 0.5% solution of haloperidol, 2–3 ml, is allowed in order to relieve severe psychomotor agitation, and then only in young and physically strong patients without significant somatic pathology. Acidosis is eliminated by intravenous drip administration of a 5% sodium bicarbonate solution (under laboratory monitoring of acid-base balance indicators). Elimination of persistent hyperthermia is achieved by intravenous administration of 2 ml of a 50% analgin solution. In the treatment of acute alcoholic hallucinosis and other alcoholic psychoses, detoxification and other somatotropic measures are combined with the prescription of antipsychotics (haloperidol, triphthazine, etc.), tranquilizers and nootropics. Antipsychotic therapy is contraindicated in acute alcoholic encephalopathy. When treating the latter, multidisciplinary intensive care is prescribed from the very beginning. infusion therapy, large doses of vitamins B1, B6, C and PP, as well as nootropics. Upon recovery from psychosis, long-term therapy using nootropics and vitamins is indicated.

In the fight against a disease caused by addiction to alcoholic beverages, it is necessary use a range of activities and do not exclude the help of specialists. We invite you to find out what alcoholic psychosis is and what to do if specialists have made such a diagnosis? We have provided answers to these questions, as well as information about the causes of the problem, how to treat the disease and recognize it in time, further in our article.

The disease is disorder mental health in humans abusing alcoholic beverages. The peculiarity of the diagnosis is the gradual formation of changes with certain symptoms throughout the entire period of development of the disease.

Most often, the first signs of the condition begin to appear with gradual progression. Therefore, in psychiatry, the disease “alcoholic psychosis” is divided into several varieties, distinguished by certain symptoms.

Symptoms of the disease appear during the second stage and depend on the specific form of the disease. At the same time, in psychiatry there is a distinction general symptoms, which points to initial stages development of the problem.

Different people, depending on psychological state and characteristics of the body, the problem may manifest itself:

Changes mood;
Increased mobility with nervous movements ;
Overly expressive facial expressions;
The appearance hallucinations auditory and visual, delirium, disorientation in space and time;
Violations sleep;
Tremors hands;
Hyperemia skin;
Promotion temperature bodies;
Irregularly blood pressure;
Headaches .

These signs are superficial and upon a deep examination of the state of the dependent person fade into the background. Depending on the specific type of psychosis, the patient will have more pronounced signs indicating the form of the disease.

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Be attentive to your loved ones. At the first signs of alcohol-induced psychosis, contact doctors . Only by working together can you return an addicted person to full life.

Alcoholic psychoses appear at 2-3 and are a disorder of mental activity. On initial stage Alcoholism psychoses are very rare.

Among the psychoses that occur with alcoholism are:

All psychoses differ in course and clinical manifestations. Psychoses due to dependence on alcohol develop not under its influence itself, but due to the products obtained after its breakdown and metabolic disorders. Thus, delirium and hallucinosis usually do not appear during the period of heavy drinking, when in human body very high levels of toxins, and during abstinence - with too sharp a decrease in blood alcohol.

Alcoholic psychosis is a consequence of alcoholism. U drinking man who is not an alcoholic, psychosis does not manifest itself even with very large doses of alcohol. Often preceded by events such as trauma, acute infections, stress. They contribute to the rapid development of psychotic reactions of the patient’s unhealthy nervous system.

Such psychoses have various shapes: chronic, acute, subacute and others. About 45% of all existing psychoses are acute, 27% are chronic and subacute. If psychosis recurs, it usually develops according to the same scenario as the primary one, but its course becomes more complicated each time. In alcoholic psychosis, the patient experiences quite strong psychoorganic disorders and disturbances in the perception of reality. Among alcoholics with 5-7 years of experience, alcoholic psychosis occurs in 13% of cases.

Delirium tremens - delirium delirium

Alcoholism and delirium tremens are two accompanying phenomena. With alcoholic delirium, the patient cannot navigate in time and place, he is aggressive and agitated.

Alcohol delirium usually begins 2-4 days after heavy drinking, but can sometimes occur during heavy drinking. The first attack of fever occurs during a long period of heavy drinking, and subsequent ones can occur during short periods of heavy drinking. Quite often, delirium tremens is preceded by a new infectious disease or an exacerbation of a chronic infection.

Signs of delirium delirium

There are symptoms that indicate the onset of delirium tremens:

Lack of craving for alcohol. Before the onset of delirium, the alcoholic completely loses desire, and in some cases even develops an aversion to alcoholic beverages.
Sudden change of mood. The approach of delirium tremens can be warned by the change of joy to unexpected melancholy, fear or depression. The patient becomes overly excited and cannot sit in one place.
Trembling of hands and feet.
Restless sleep, insomnia, nightmares. After waking up, a person faces terrible visual images, he can even hear sounds that are not really there.

How can you avoid delirium tremens? The answer is clear: you need to stop drinking if it hasn’t happened yet. If the disease is already present, you need to be treated for alcoholism. Yes, there are different drugs and medications for this disease.

Hallucinations in delirium delirium

Attacks of delirium tremens usually occur in dark time days. Hallucinations are usually dominated by images of amphibians, insects and small animals, such as snakes, spiders, rats or mice, which a person is afraid of in life. in good condition. In ancient times, believing alcoholics often imagined devils during delirium tremens. There may also be visions of nets, ropes, cobwebs from which a person cannot get out, or various scenes from horror films where chaos and destruction reign. Such pictures in the perception of delirium tremens are not three-dimensional; rather, they resemble watching a movie. Auditory hallucinations are directly related to what the patient imagines: he may hear screams of horror, animal cries or threats. During delirium tremens, cases of painful, unreasonable jealousy of an alcoholic are not uncommon.

Everything that the patient hears and sees in this state is shown in his facial expressions. Grimaces of confusion, horror and fear appear on the person’s face. He tries to throw off imaginary reptiles or insects, tries to hide, or pushes someone away from him. In addition to auditory and visual ones, the patient may be haunted by tactile hallucinations. He feels how amphibians or insects crawl over him, how he is bitten, beaten or cut. This condition is characterized by a sensation in the mouth foreign body: a person tries in every possible way to pull it out with his hands or spit it out. Speech during an attack is slurred and abrupt; most often he speaks individual lines, conducting a conversation with images of hallucinations.

Dangers of Delirium

Delirium tremens (or, as alcoholics call it, squirrel) is a psychosis that poses a great danger to the life and health of the patient and the people around him. In this state, a person can, for example, jump out of a window. Trying to get rid of terrible hallucinations or obeying the voices in his head, the patient may even commit suicide.

During delirium tremens, the patient loses orientation in space: he completely does not understand where to go and where he is. Although he can provide his personal name and other information that relates to his personality very accurately.

Hallucinations related to delirium tremens weaken during the daytime, and become bright again in the evening and at night. There are also gaps between them when the visions release the patient a little, and he can talk about them.

Alcoholic psychosis: hallucinosis

This type of psychosis manifests itself in 5-11% of cases of alcoholic mental disorders and ranks second in prevalence, second only to delirium. Most often, hallucinosis occurs in alcoholic women and occurs, like delirium, after long-term alcohol abuse. But, unlike alcoholic delirium, it occurs with fairly clear consciousness and normal orientation in place and time. Auditory hallucinations usually predominate, while tactile and visual hallucinations are rare. Patients completely retain memories of their behavior and feelings in a state of psychosis.

Alcoholic hallucinosis can be divided into 3 types: acute, subacute and chronic.

Acute hallucinosis begins against the background of a hangover and becomes psychopathological.

This psychosis has the following symptoms:

rare tactile and visual hallucinations;
auditory hallucinations – separate sounds, calls, voices of different timbres;
persecution mania (the patient thinks that someone wants to kill or mock him);
decreased emotional background (sullenness, fear, gloomy mood);
behavior that is directly related to hallucinations (attempts to run away, hide);
arming yourself with various items to protect yourself;
attacking others in order to avoid aggression from them (imaginary).

Acute alcoholic psychosis can last up to several weeks.

Subacute hallucinosis manifests itself over several months. It is characterized by exacerbations. The patient is worried about anxiety and fear. He moves little, stays in bed for a long time and listens to voices. In this state, delirium is associated with self-accusation, because of this, patients have suicidal tendencies.

In alcoholism, chronic hallucinosis usually begins after the patient has suffered acute psychoses. Auditory hallucinations and ideas of persecution begin immediately. Then only auditory hallucinations remain, but they bother the patient for a very long time. He can simultaneously hear several voices arguing with each other. Over time, the patient begins to get used to these voices, answering them, but his mood remains gloomy.

If this psychosis continues for more than 2 years, then treatment may not lead to positive result. However, treatment of alcoholic psychosis, constant therapy with abstinence from alcohol can relieve the patient from hallucinations.

Alcohol paranoid

This type of psychosis also has chronic and acute forms, and it is characterized by systematic delusions, where images of persecution, jealousy, poisoning, etc. predominate. The patient ceases to adequately evaluate the people around him and reality.

Alcoholic paranoid occurs as a primary delusion that is not associated with hallucinations. But in some cases there is still a dependence on hallucinations. Often with this psychosis there are delusional ideas that are associated with jealousy. If jealousy becomes the main thing in a person’s delusional experiences, then ideas of poisoning, persecution, etc. are mixed in with it, which forms the picture of the paranoid syndrome.

Patients with alcoholic paranoia experience increased temperature, pressure fluctuations, nightmares, sleep disturbances, heat intolerance, and dizziness. A person ceases to control his emotions, becomes unrestrained, angry, or, conversely, very inhibited. He loses control over his moral and ethical behavior.

Delusional psychosis in alcoholism

In alcoholism, delusional psychosis occurs when the body is intoxicated, usually in difficult situations for the body: when tired, on the road, after an injury, in an unfamiliar place. The leading symptom of this psychosis is delusional ideas of persecution.

The patient in this state thinks that people are plotting against him and his family, trying to kill or torture him in sophisticated ways. In an attempt to escape, a person is often the first to attack the “pursuer” or attempt to commit suicide. In a state of delusional psychosis, patients are afraid of being poisoned, so they begin to refuse medication. Under the influence of delusional ideas, people cease to perceive reality.

In 10% of cases of such alcoholic psychosis, delusions of jealousy are observed. When his wife reproaches him for infidelity, the marital relationship cools down, and the alcoholic begins to believe that his wife has taken a lover. The delusional mood is greatly complemented by the fact that most alcoholics are impotent. They blame their wives for their troubles, of course, and it is simply impossible to convince an alcoholic that he is wrong.

Alcoholic pseudoparalysis

In people who use for a long time alcohol surrogates, pseudoparalysis quite often develops. This disease occurs against the background of alcoholism with an eating disorder with vitamin deficiency and metabolic disorders. Such patients begin to degrade intellectually; they are in a state of euphoria and complacency, not noticing their own miscalculations and mistakes. A complete reassessment of personality occurs and because of this, the alcoholic develops delusions of grandeur, which can be very difficult to cure.

Then the mental activity of the patients begins to decline, delusional experiences and hallucinations weaken, and the patients become indifferent and lethargic.

Neurological symptoms of pseudoparalysis:

poor pupil reaction;
pain in the limbs;
dysarthric speech;
tremor of fingers;
impaired reflexes in the tendons.

It is important to treat pseudoparalysis before neurological symptoms develop.

Alcoholic encephalopathy

Encephalopathy in chronic or acute forms occurs in people with a long history of drinking alcoholic beverages: mainly surrogates, strong wines and vodka. This psychosis is observed in chronic or binge alcoholics who abuse alcohol frequently and in large quantities. Alcoholic encephalopathy is characterized by neurological and somatic disorders.

A person with alcoholic encephalopathy experiences hypovitaminosis, metabolic disorders, and a lack of thymine, which is aggravated by disruption of the normal functioning of the liver and leads to a rapid deterioration in brain activity, which is almost impossible to cure. With encephalopathy, the patient experiences an imbalance nicotinic acid and pyridoxine.

Hemorrhagic polyencephalitis

Among acute psychoses, the main place is occupied by Wernicke's disease or hemorrhagic polyencephalitis. This is a rather complex disease that combines neurological, mental and somatic disorders based on degenerative and destructive processes.

People suffering from this psychosis experience tremors, sleep disturbances, oculomotor disorders, dysarthria, as well as loss of respiratory, pharyngeal, sneezing and palatal reflexes.

Mental disorders are manifested by a state of delirium or occupational delirium with very strong agitation. This condition can result in stunning.

Signs of hemorrhagic polyencephalitis:

The likelihood of death is very high.

Alcohol depression

Alcoholic depression as an independent disease is very rare. It can last from several days to several weeks. A person in this state feels irritable and melancholy; he accuses his surroundings of being insensitive to him, while he acutely feels his guilt and inferiority.

This psychosis is characterized by mood swings. In this case, the patient may experience anxiety, dysphoria, and tearfulness. Suicidal thoughts appear, so a patient in this state must be constantly monitored. This can happen both after binge drinking and during it.

Dipsomania in alcoholism

Dipsomania is manifested in a person by the desire for binge drinking - prolonged drunkenness. This type of psychosis occurs in patients suffering from epilepsy, endocrine psychosyndrome, manic depression. Long-term drunkenness can last up to 3 weeks, starting during long abstinence from alcoholic drinks. It also ends suddenly, and the person may develop an aversion to alcohol.

An attack of dipsomania usually occurs after a sleep disorder or some other moment that depletes the alcoholic’s body. Against this background, alcoholic psychosis can develop very rapidly and painfully.

Antabuse psychosis

When treating alcoholism with the drug teturam (disulfiram, antabuse) severe complication is antabuse psychosis. Too large doses of this drug or the sensitivity of the human body to it due to organic inferiority of the nervous system, chronic alcohol intoxication or head trauma often lead to very severe psychosis. This psychosis has 3 stages of development.

The prodromal (first) stage lasts from several days to several weeks, and is characterized by drowsiness, dizziness, sleep disturbance, lethargy in the patient, depressed mood, an unpleasant feeling in the area of the heart.

At the height of the disease, there are several development options:

with paranoid and hallucinatory-paranoid mental disorders;
with confused consciousness;
with a manic state.

At the last stage of this psychosis, lethargy, weakness, emotional lability. The patient does not remember well his condition, which was in acute period diseases. The duration of psychosis can last up to 2 months.

In antabuse psychosis, the proportion of suicides is high. Their reasons are different: sometimes suicide attempts occur due to affective fluctuations during alcohol intoxication, sometimes with personal characteristics, and in some cases with different life situations.

The frequency of suicides depends entirely on the degree of degradation of the patient. More often, suicide is committed by patients with fully preserved intellect, and not by the mentally retarded. Very often, the cause of such actions is conflict in the family. Quite often there are cases when, due to the actions of a patient with delusions of jealousy, several people suffer: an alleged rival, a spouse, the patient’s children. Typically, suicidal acts are committed by an alcoholic during an affective outburst in a state of depression.

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Comments

Megan92 () 2 weeks ago

Has anyone succeeded in ridding their husband of alcoholism? My drink never stops, I don’t know what to do anymore ((I was thinking about getting a divorce, but I don’t want to leave the child without a father, and I feel sorry for my husband, he’s a great person when he doesn’t drink

Daria () 2 weeks ago

I have already tried so many things, and only after reading this article, I was able to wean my husband off alcohol; now he doesn’t drink at all, even on holidays.

Megan92 () 13 days ago

Daria () 12 days ago

Megan92, that’s what I wrote in my first comment) I’ll duplicate it just in case - link to article.

Sonya 10 days ago

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Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? They sell it on the Internet because stores and pharmacies charge outrageous markups. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now they sell everything on the Internet - from clothes to TVs and furniture.

A dangerous complication of alcoholism is alcoholic psychosis - symptoms and treatment make it clear that getting rid of delirium and delusional ideas will not be easy even in a hospital setting. This critical condition is not limited to withdrawal syndrome, irreversible changes occur in the psyche of a chronic alcoholic, his worldview. Alcoholic psychosis occurs when a smaller dose of ethanol enters the blood, and this is a problem. It will be very difficult to recover and return to a full life.

What is alcoholic psychosis

This acute mental disorder is provoked by prolonged abuse of alcoholic beverages. Simply put, this is a serious complication of alcoholism, which, in addition to insomnia, causes amnesia and delirium tremens. The disease is chronic, however, if you stop the attack within 10 days, you can achieve a stable and very long period of remission. More often, male alcoholics suffer from this characteristic pathology, but one should not exclude the development of alcoholic psychosis in female body. This is an official diagnosis, which has an ICD-10 code F 10.4.

Causes

The main provoking factor is alcoholism, which gradually destroys all internal organs and systems of the body. This is a pathological process lasting more than a year. Alcohol psychosis progresses more often in chronic alcoholics Stages 2 and 3, prone to recurrence. Additional motivating factors are:

social and household factor;
genetic predisposition;
metabolic disorders and chemical composition blood;
long-term stress, mental trauma;
chronic fatigue, apathy;
physical and mental overload;
low level comfort.

Symptoms

If a patient falls into alcoholic depression, these are the first prerequisites for an exacerbation of psychosis. cure chronic illness It’s not easy, especially since the clinical picture is only getting worse. Pathological process begins with acute intoxication of the body, does not exclude the appearance of systemic and neurological symptoms. It is recommended to pay attention to the following changes in general health:

impaired breathing with hoarseness;
cyanosis around the eyes, corners of the mouth;
nightmares;
obsessions;
delusions with visual hallucinations;
attacks of emotional excitement;
progressive delirium;
paranoia, fit of hysteria;
progressive mental disorder;
suicidal tendencies;
symptoms of dementia;
progressive epilepsy;
panic during auditory hallucinations.

Types of alcoholic psychosis

Long-term alcohol intoxication in the absence of desire on the part of the patient, it is difficult to cure, so psychosis develops over time. Considering extensive list delusional disorders, narcologists provide the following conditional classification for quickly diagnosing a patient with alcoholism. So, the following types of alcoholic psychosis are distinguished:

Alcohol delirium

In essence, this is “delirium tremens”, which in case of somatic disorders drives the patient to madness. A dangerous attack is often associated with a sharp decrease in the dose of ethanol in the blood after a long binge. Not only is there complete degradation of personality, but it also creates real threat society from a violent alcoholic. Its actions during alcoholic delirium are difficult to guess and predict.

Hallucinosis

This pathology is no longer accompanied by a physical disorder, but by a psychological one. The patient personally experiences auditory and visual hallucinations, exists in a state severe stress, emotional instability and alcohol addiction. He constantly hears other voices, with whom he even has a conversation. Eye symptoms in practice they are much less common, but also become an eloquent manifestation of alcoholic psychosis, requiring timely treatment.

Othello syndrome

This symptom is associated with intense jealousy, which borders on signs of insanity. In such a clinical picture, even a human life may depend on the further behavior of patients, since an alcoholic in a state of passion is able to “strangle” the object of jealousy or a conditional rival. Therefore, with long-term drinking bouts, the prognosis is unfavorable; you can end up “behind bars” after sobering up.

Korsakoff's syndrome

For progressive alcoholic encephalopathies binge alcoholic periodically loses memory. It's about about temporary episodes of amnesia, which he tries to make up for with his own fantasies. Each time he comes up with a new story about what happened, but in reality everything was completely different. Such stories cause alarm among relatives, so treatment for alcoholic psychosis should follow immediately. It is important to understand that Korsakoff's syndrome belongs to the category of chronic alcoholic encephalopathies.

Acute alcoholic psychosis

Gaye-Wernicke encephalopathy occurs exclusively in an acute form, and develops against the background of severe delirium. In autonomic disorders, extensive brain damage is observed due to a deficiency of thiamine - vitamin B1 against the background of chronic alcoholism, malnutrition, and incessant vomiting. Metal-alcohol psychosis of this type is accompanied by increased sleepiness, disturbed sleep phase, general weakness in the limbs, nightmares and a feeling of emptiness. All manifestations depressive disorders difficult to treat.

Treatment of alcoholic psychosis

With prolonged drinking bouts, extensive disturbances in the psycho-emotional state cannot be ruled out, which require timely correction. using medicinal methods. Treatment is carried out in a hospital, the main goal is to reduce the risk of developing irreversible damage to the brain and internal organs and systems. If post-alcohol psychosis is diagnosed, general recommendations certified narcologists are presented below:

Alcoholic with severe symptoms requires hospitalization, otherwise he may harm himself and others.
To get rid of the symptoms of psychosis, it is necessary to carry out infusion therapy in order to effectively cleanse the systemic bloodstream of heavy metals.
During attacks of psychosis accompanying hangover syndrome, the patient must be isolated from others.

Medications

After performing a series of tests to make a final diagnosis, it is possible to get rid of such an extensive pathology only with integrated approach. basis intensive care in a hospital setting is infusion therapy for the rapid and safe removal of alcohol breakdown products. Additionally, narcologists appoint representatives of the following pharmacological groups:

psychotropic drugs to eliminate symptoms of psychosis;
saline solutions for high-quality blood purification;
a mixture of phenobarbital and alcohol with the addition of water to fix the alcoholic;
vitamin B1 in large doses to avoid extensive brain damage;
nootropic drugs, tranquilizers to calm a violent patient;
sleeping pills to pacify a violent patient;
antipsychotics recommended for the patient with thoughts of suicide;
multivitamin complexes for quick recovery body.

Specified medical supplies can be prescribed only on an individual basis with adjustment of daily dosages. Treatment unpleasant symptoms psychosis due to alcohol dependence should occur only in a hospital, under strict medical supervision. Here are effective medications in a given direction:

Diazepam. 0.5% solution intended to perform intramuscular injections. It is recommended to administer 2–4 ml of medication at a time, up to 2–3 approaches per day. Continue treatment until the unpleasant symptoms disappear completely.
Carbamazepine. This is a drug in tablet form that is prescribed when seizures occur. The daily dose is 1.2 g, an overdose is completely excluded (dangerous to the health of an alcoholic).

Psychotropic drugs

In case of dipsomania without representatives of the specified pharmacological group, successful treatment of the patient is excluded. To relieve symptoms of aggression and inappropriate behavior, narcologists recommend the following psychotropic drugs in hospital:

Aminazine. Treatment solution with a concentration of 2.5%. It is recommended to administer 2–3 ml, with daily doses adjusted individually depending on the unpleasant symptoms of psychosis. It can be replaced with Tizercin solution - the principle of use is similar.
Seduxen. Another medicinal solution concentration 0.5% for drip administration. It is recommended to administer 3 ml of the medicine 2 to 3 times a day until the symptoms completely disappear.

Consequences

If the symptoms of alcoholic psychosis are not eliminated in a timely manner, the patient becomes socially dangerous and can threaten the lives of healthy and adequate people. His actions are difficult to predict, and his conversations do not have a calming effect. Therefore, a violent alcoholic must be urgently neutralized and isolated, and treatment must be carried out only in specialized clinic. Among the potential complications, narcologists highlight:

gradual but steady decline in mental capacity;
progressive amnesia;
regular spasms and tremors of the limbs;
complete degradation of personality;
extensive damage to internal organs and systems;
death at a relatively young age;
gradual development of chronic alcoholic psychosis with frequent relapses.

Video

Alcoholic psychosis is a pathological state of the human psyche that occurs at stages 2-3 of alcoholism, that is, after about 5 years of abuse of alcohol-containing drinks. Humanity has known about this disease since ancient times, but for a very long time it was not included in the list of diseases. Modern medicine classifies it as a disease that is difficult to treat. After all, a strong craving for alcohol can be treated if the drinker himself is interested in this, and not just his family or friends.

Alcoholic psychosis occurs as a result of constant poisoning of the human body, especially the brain, with decay products ethyl alcohol. It is not just a complication of alcoholism, but one of its most striking symptoms.

Factors causing the disease

Excessive consumption of alcoholic beverages over several years is main reason that causes this disease. Ethanol breakdown products negatively affect all organs and disrupt normal metabolism. Except liver, pancreas, hearts, the nervous system receives a big blow. Due to massive cell death, the brain of a long-term alcoholic decreases in volume and cannot cope with its functions. Also an important factor in the occurrence of pathological mental states associated with alcohol abuse is genetic predisposition. Less common among the reasons is social environment and conditions of everyday life.

Other factors can also become catalysts for the development of alcoholic psychosis: recent head trauma, infectious disease, severe stress.

Alcohol-related mental disorders occur during abstinence, that is, after stopping a long binge. Based on this, in modern science they are called meta-alcohol psychoses (the prefix “meta-”, which came from Greek language, means “after”, “next”).

Forms of alcoholic psychosis

In medicine, there are three main forms of the disease: acute, subacute, chronic. Acute alcoholic psychosis is characterized by several phases clinical manifestations, often combined with each other. Psychosis in acute form is alcoholic delirium, which lasts no more than ten days. Other types of alcoholic psychoses are considered acute if they can be cured within a month. Subacute or prolonged psychosis is considered such if it lasts within six months, and chronic psychosis lasts more than six months.

Classification of alcohol-related mental disorders

There are several main groups of alcoholic psychoses, which in turn, based on different symptoms, are divided into types.

Alcoholic delirium: typical, abortive, excruciating, atypical.
Alcoholic hallucinosis: verbal, with sensory delirium, with mental automatisms.
Alcoholic delusional psychoses: alcoholic paranoids, delusions of jealousy.
Alcoholic encephalopathies: alcoholic pseudoparalysis, Gaye-Wernicke's disease, Korsakoff's psychosis.

In the absence of appropriate treatment in conditions medical institution and complete abstinence from alcohol, the prognosis for each type of psychosis is unfavorable.

Alcohol delirium

Among alcoholics, delirium is called delirium tremens or delirium tremens. AlD refers to acute psychotic states characteristic of last stages alcoholism. AlD usually manifests itself between the ages of 25 and 60 in individuals who have been abusing alcohol for over 5 years. Severe AlD occurs after binges that periodically last for about 10-15 years. Lead times are subject to availability or totality. unfavorable factors, named above.

The factors that make up the pathogenesis of delirium delirium include:

direct toxic effects on the nervous system of ethanol and its breakdown products;
problems with functioning nerve tissue due to a deficiency of biologically active substances;
toxic effects of amino acids that excite the nervous system;
liver damage.

At risk of developing delirium tremens are people who were forced to stop drinking alcoholic beverages due to emergency hospitalization in a medical hospital. The patient may have problems with the heart, liver or other organs, and after a few days symptoms of alcoholic psychosis appear.

The course of the disease can consist of three stages.

Threatening delirium. Mostly with the onset of twilight, the patient becomes restless and anxious, and visual hallucinations begin. He can fiddle with clothes and talk to someone he has dreamed of. Among the physical signs it is possible profuse sweating, slight increase in temperature. At this stage, delirium tremens may end as unexpectedly as it began.
Complete delirium. This stage is characterized by the appearance of not only visual, but also auditory and tactile hallucinations. Often, alcoholics see insects and rodents, they see deceased relatives and hear their voices. The patient feels that someone is pinching him, biting him, beating him, that spiders are crawling on him. A person loses his bearings in space and time. His hands or even his whole body begin to tremble, shortness of breath begins, color skin- pale, white. All this is extremely alarming symptoms and treatment of such a patient must be carried out in a medical institution, since the disease can very quickly move into the next phase.
Delirium, life-threatening. At this stage there are all the symptoms of a distorted perception of reality, however autonomic disorders appear in a more severe form. Instead of excitement, lethargy sets in, speech becomes quiet and mumbling, the person does not respond to external commands, does not feel thirst or hunger. Depression of consciousness can develop into. Cerebral edema, pneumonia, acute liver, kidney and heart failure develop. With such complications, the prognosis is often death in a short time.

Often a decrease in motor activity, a decrease in sweating and normalization blood pressure doctors perceive it as an improvement in the patient’s condition, but this is a sign of deterioration.

Alcoholic hallucinosis

Acute alcoholic hallucinosis is in 2nd place in the frequency of occurrence after delirium. The disease is characterized by a predominance of pronounced auditory hallucinations, and it is predominantly women who are exposed to it. The course of hallucinosis can be acute, prolonged or chronic forms. This disorder begins with the appearance of anxiety and fear, sleep disturbances. Next, hallucinations appear in the form of individual sounds or words and entire phrases. In this case, a person can clearly say where he hears these sounds from. The acute form of the disease usually ends after deep sleep.

If the disease becomes protracted, hallucinations are accompanied by persecutory mania, and patients may experience panic attacks. Alcoholic psychosis, the symptoms of which appear for a long time, requires mandatory treatment by specialists, since a person can harm himself or others. Chronic alcoholic psychoses can last up to several years.

Alcoholic delusional psychosis

To this view mental disorders include alcoholic paranoid, alcoholic delusions of jealousy. As the name implies, delusional alcoholic psychosis is characterized by the presence of delusional ideas of the alcoholic about those around him. The course of paranoia can be acute and subacute. It seems to a person that something bad is being plotted against him, for example, his murder. In the acute stage, the behavior of an alcoholic is impulsive: he may suddenly begin to run away or, on the contrary, attack others. With a long duration of the disease, a certain systematization of delirium occurs; the patient tries not to contact individuals whom he suspects of malicious intent.

Delusions of jealousy are often the companion of experienced alcoholics over the age of 40. This type of psychosis begins gradually. It seems to the husband that his wife treats him coolly, constantly stays late at work, and often goes somewhere on the weekends. Suspicions of a spouse's infidelity are reinforced in the form of fictitious evidence and verbal hallucinations. The patient can monitor his wife and apply physical strength, seeking a confession of treason.

Alcoholic encephalopathies

These are severe alcoholic psychoses, which are characterized by a combination of mental disorders with neurological and physical disorders, the latter often dominating the overall clinical picture.

Gaye-Wernicke encephalopathy is an acute form of the disease, often resulting from severe delirium in weakened patients, with complex injuries, and infections. The onset of psychosis is represented by occupational or excruciating delirium. In the first case, the person thinks that he is at work, so he performs professional movements. In the second case, the patient does not recognize his relatives and mutters unintelligibly. The condition quickly deteriorates: cardiac dysfunction, urinary and fecal incontinence, and stupor develop, which progresses to a state of coma. If treatment for alcoholic psychosis is not started on time, death occurs within a couple of days at most.

Korsakoff's psychosis is a chronic encephalopathy and can last for months or years. Its manifestations: amnesia, pseudomemories, impoverished speech and motor functions. Symptoms of alcoholic pseudoparalysis are dementia, loss of acquired knowledge and skills, and lack of awareness of the disease.

Treatment of severe alcoholic psychoses

Alcoholic psychosis, which is treated in a hospital, has a greater chance of being stopped. Therapy for such diseases includes several components:

detoxification (freeing the body from toxic substances);
correction of metabolic disorders (elimination of vitamin deficiency and oxygen starvation fabrics);
restoration of water and acid-base balance;
elimination of psychomotor agitation and sleep disturbances.

Pledge successful treatment – complete failure from alcohol, which can be achieved well with the help of specialized medications.

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