The concept of alcoholic psychoses, clinical symptoms of the development of this pathological condition. The main forms of the disease and the main aspects of treatment. Alcoholic psychosis is a pathological condition of the human body, which is observed against the background of a long period of alcoholism and occurs a few days after drinking alcoholic beverages. Statistics report the widespread prevalence of this disease. Almost 10% of patients with chronic alcoholism suffer from such psychosis. Recently, this pathology is increasingly common among adolescents and people who systematically drink alcohol for only 3-4 years. This negative trend requires immediate intervention and careful monitoring of all patients with alcoholism, even at a mild stage.
The causes of alcoholic psychosis
To date, the etiology of alcoholic psychosis has not been sufficiently studied to talk about the specific reasons for its development. You can only determine the conditions in which this condition usually develops. At the same time, the terms and manifestations may differ, depending on the individual characteristics of the organism of each patient. The main conditions for the development of alcoholic psychoses:
- II-III stage of alcoholism … Psychosis very rarely develops immediately after the onset of systematic alcohol use. Most often this occurs in the presence of a reduced tolerance to alcoholic beverages, symptoms of alcoholism, disorders of the central nervous system.
- Withdrawal symptoms … It is extremely rare that ordinary alcohol intoxication can cause psychosis. At the heart of the negative effect on the brain and the development of psychotic symptoms is the poisoning of the body with the decay products of alcoholic beverages. That is, alcoholic psychosis may develop some time after the last consumption of alcohol against the background of withdrawal symptoms.
- Young age … The rapid development of psychosis in adolescents is explained by the immaturity of the central nervous system, as well as an insufficient level of development of enzymatic reactions. The body has not yet learned to cope with chronic intoxication and quickly succumbs to the influence of alcohol breakdown products.
- Damage … A history of infectious diseases of the brain or trauma to the central nervous system increases the likelihood of developing alcoholic psychosis even with a short duration of the disease, and also aggravates the course of this pathological condition.
- Stress … More often, alcoholic psychosis occurs in people with mental disorders, in those who are in nervous tension. Stress at home or at work causes mental instability, which, together with the influence of alcohol, becomes a favorable background for the development of this disease.
- Genetic predisposition … Very often, psychotic manifestations of alcoholism are observed in those people whose relatives suffered or suffer from similar diseases. Genes are responsible for the predisposed sensitivity of the central nervous system to the breakdown products of ethanol. In this case, the likelihood of developing symptoms of alcoholic psychosis increases significantly.
Forms of alcoholic psychosis in humans
Symptoms of alcoholic psychoses may differ depending on the individual characteristics of each organism. Also, the form of manifestations depends on the gender of the patient. Women are more likely to suffer from hallucinations and paranoia. For men, the development of alcoholic delirium is more typical. There are also chronic forms that are extremely rare.
Delirium
Delirium is also popularly called "delirium tremens", as it often causes the body temperature to rise. Among all forms of alcoholic psychosis, this is the most common. Almost 80% of cases are due to delirium.
It usually develops 2-5 days after the last consumption of alcoholic beverages. In some cases, symptoms may be observed a little earlier than this period. Fatal outcomes are less common in relation to other forms of psychosis - in only 2-3% of patients. Manifestations of delirium begin with mood swings, sleep disturbances. Sometimes in the early stages of alcoholic psychosis, a small tremor of the limbs can be observed. Then delirious clouding of consciousness develops. The patient remembers and understands who he is, but it is difficult to navigate in space and time. It is difficult for him to name the day of the week or the date, and it is also difficult for him to determine his location. Visual hallucinations may then develop. At first, they will take the form of various insects, then they will transform into large animals and other frightening visions (devils, aliens). Usually the patient is shackled by fear of such hallucinatory experiences and tries to run away.
In addition, there is a violation of tactile perception. Most often, there is a feeling that goose bumps or other small insects are crawling over the skin. Patients shy away from every touch and are in an extremely frightened state. The behavior of patients with delirium may also be accompanied by psychomotor agitation, which is dangerous for them in the first place and for the people around them. The patient's somatic condition is also affected. Most often, delirium is accompanied by vegetative manifestations. These are tachycardia, increased sweating, muscle weakness, pallor of the skin, a decrease in blood pressure, an increase in body temperature.
The duration of this condition can fluctuate. Usually after 1-4 days, the manifestations are leveled. This comes after a long deep sleep. In this case, memories can be partially lost, and the person does not remember his state. He wakes up weak and needs rest. There are also severe forms of delirium. For example, exaggerated, chronic, abortive, atypical. They proceed with great complications, in comparison with the classical variant, but they are very rare.
Hallucinosis
This form of alcoholic psychosis is observed more often in patients with a long alcoholic experience (10-15 years of systematic use of alcoholic beverages). There is a chronic intoxication of the body, which at one point reaches the psychotic level. Alcoholic hallucinosis begins from prolonged binge drinking or in a state of withdrawal. As with delirium, the clinical picture unfolds with mood swings, anxiety, limb tremors. Clouding of consciousness in this state is very rare. Usually patients are oriented in themselves, time and space. Then perception disorders join.
Auditory hallucinations are most common. These are familiar or unfamiliar voices that constantly discuss the patient's behavior, can insult or scold. Delusional ideas develop on the basis of such hallucinations. A person is constantly afraid that the threats he has heard may come true, behaves extremely carefully, and hides. The behavior of a patient with alcoholic hallucinosis is quite dangerous, both for himself and for those close to him. That is why this form of psychosis requires the immediate assistance of specialists. Symptoms last much longer than delirium. Usually, improvement occurs in a couple of days, but hallucinosis can last for weeks.
Paranoid
This pathology also develops after a long period of alcohol abuse. For some time, anxiety, increased irritability, anxiety, and sleep disturbances are observed. Then, against this background, the delusions of persecution are formed. A person begins to fear for his life and health, focuses all his attention on his pathological reasoning. The duration of the course of this disease depends on its form. Acute paranoid develops rather quickly and lasts up to several weeks. At the same time, the symptomatology is pronounced, delusional ideas prevail in it. The lingering paranoid is characterized by a blurred beginning, which is very difficult to notice. Behavior changes slowly. At first, mistrust appears, excessive caution, then suspicions and fear develop. Sometimes, instead of delusions of persecution, ideas of jealousy are observed. A person builds pathological assumptions around the infidelity of his half. Most often, this form is observed in men. They begin to notice the slightest details in the behavior of their wife / girlfriend, associate it with treason and try to find evidence among everyday trifles. Very often delirium of jealousy poses a direct threat to the patient's wife or to the one who fell under “suspicion” as a lover. This type of paranoid can last for months and requires appropriate treatment.
Korsakov syndrome
This condition is also known as amnestic syndrome. It can be observed from the age of 40-45 years. Most often, at the time of the development of Korsakov's syndrome, there is a history of delirium or encephalopathy. That is, amnestic manifestations are residual symptoms of prolonged alcohol intoxication.
First of all, the patient observes that he cannot remember current events, it is difficult for him to reproduce in his memory some moments that happened very recently. During the test of memorization of 10 simple words, the patient cannot name more than 3 of them. This indicates fixative amnesia. Over time, with this form of alcoholic psychosis, the memory of distant events is erased. Entire passages from youth, important memories disappear. They can be replaced by invented ones, confused with others in chronology. People often fill in gaps in memory with events that never happened, while drawing their imagination from films, newspapers, and books.
Encephalopathy
This pathology is a combination of mental changes and neurological disorders after a long period of alcoholism. It can develop after 7-8 years of chronic alcohol use. Symptoms of acute encephalopathy due to alcoholism are combined in Gaie-Wernicke syndrome. Its signs can be conditionally divided into several groups:
- Sleep disturbances … Patients often complain of inability to sleep, wake up at night and feel tired during the day. At the same time, hypnotics do not have a significant effect. In addition, nightmares are observed, due to which the quality of sleep deteriorates.
- Dyspeptic disorder … Very often, patients complain of epigastric pain, heartburn, nausea and even vomiting. Appetite disappears over time. Almost everyone has an eructation of sour and unpleasant contents. Diarrhea or constipation occurs periodically.
- Mental symptoms … First of all, asthenia is manifested - increased fatigue with physical or mental stress. In addition, there is a clouding of consciousness. Usually it reaches the level of stunning, less often - stupor. Perceptual disorders are also present - hallucinatory experiences of a different nature. Thinking is incoherent, the patient constantly says meaningless phrases. A person cannot correctly understand what is happening around him, he is disoriented and scared.
- Movement disorders … At the initial stage, ataxia is manifested - a violation of coordination and balance. It is difficult for a person to walk, he is constantly bent to the side. Then the nerve fibers in the cranial nerves are affected. Usually the third oculomotor pair suffers first. Because of this, the ability to move the eye is disrupted, and muscle paralysis occurs.
Features of the treatment of alcoholic psychosis
Any form of alcoholic psychosis requires immediate intervention by specialists, since this pathological condition poses a serious threat to the patient's health and life. That is why, in the event of such symptoms, you should definitely seek help. Only in intensive care can positive results be achieved. Treatment of alcoholic psychoses consists of several important points.
Restoration of hemostasis
Therapy of any form of psychosis requires immediate fluid therapy with drugs that will help remove toxic substances and ethanol breakdown products from the body. The volume and qualitative composition of the detoxification mixture is calculated individually, according to the constitutional characteristics of the patient, as well as the electrolyte balance. In case of violation of the latter, its correction and careful monitoring will be required. With the help of infusions, hemodynamics are restored, drugs are injected to maintain the work of the heart muscle. Blood pressure, tachycardia and other symptoms of the hemodynamic system are corrected. It is often necessary to restore the correct acid-base balance with the help of appropriate infusion solutions. They are able to quickly and harmlessly correct balance, bringing it back to normal.
Against the background of such massive infusion therapy, it is important to prevent cerebral or pulmonary edema. These organs are most sensitive to overflow in the bloodstream. For this, diuretics are used, which in turn can affect the electrolyte balance. Therefore, the selection of drugs should be dealt with by a qualified doctor who understands how to treat alcoholic psychosis correctly, combining drugs of various pharmacological groups.
Therapy of mental manifestations
First of all, it is necessary to remove psychomotor agitation, if present. If a person is unable to control his body, he can harm not only himself, but also those around him. Against the background of hallucinatory experiences, his actions are unpredictable, therefore they require immediate correction.
Usually, antipsychotics with a sedative effect are used for these purposes. As a last resort, Sibazon is administered. The most important thing is to give the patient rest and rejuvenation.
With hallucinations and paranoia, it is necessary to prescribe antipsychotics to relieve this symptomatology. Most often, Haloperidol is used for this, but it is possible to prescribe other antipsychotics, depending on the nature of the symptoms, individual tolerance. It is necessary to choose the correct dosage so as not to cause side effects.
In addition, it is important to avoid the severe consequences of psychosis in the form of seizures. Usually, adjusting the electrolyte balance, you can achieve a relatively successful outcome, but if necessary, it is possible to prescribe drugs that block seizures. Sometimes muscle relaxants are added to the therapy regimen.
Correction of somatic pathology
Alcohol psychosis often causes complications from almost all organs and systems of the body. That is why it is necessary to carefully monitor the patient's condition, to correct the existing disturbances in hemodynamics, water, electrolyte and metabolic balance in time. It is important to prevent the development of renal or hepatic failure, therefore, funds should be introduced into therapy that will support these organs for the period of alcoholic psychosis. Also, to ensure the normal functioning of the brain, nootropic drugs are administered. They will improve cognitive processes and reduce the negative effects of this disease. Vitamin therapy plays an important role. Timely administration of B vitamins, nicotinic acid can improve the transmission of nerve impulses and the general condition of the patient. Most often, these drugs should be injected for greater effectiveness and quicker impact. This applies to virtually all therapy for alcoholic psychosis.
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This pathology is a rather serious disease, the treatment of which should be dealt with in a hospital setting. If you have minimal symptoms, you should definitely consult a doctor or call an ambulance. In this case, several hours of delay can cost the person his life. That is why you do not need to self-medicate and hope that the symptoms will go away. The disease can develop into chronic alcoholic psychosis. Only qualified therapy can help the patient get out of this state.
