A Study of Psychosocial Factors and Personality Traits Associated With Emergence of Psychotic Disorder in Patients with Alcohol Dependence. (original) (raw)
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Treatment of Alcohol-Induced Psychotic Disorder (Alcoholic Hallucinosis)—A Systematic Review
Alcohol and Alcoholism, 2017
Aims: To evaluate the effectiveness of evidence based treatments for alcohol-induced psychotic disorder (AIPD) as described by ICD-10 and DSM-5, a condition that is distinct from schizophrenia and has a close relationship with alcohol withdrawal states. Method: Systematic review using PRISMA guidelines. Results: Of 6205 abstracts found, fifteen studies and ten case reports met criteria and were examined. Larger studies examined the use of first-generation antipsychotic drugs, reporting full or partial remission in most patients. Newer case reports report similar results using second generation antipsychotic drugs. Novel treatments, such as those acting on GABA receptors reported low numbers of patients in remission. Some large studies report the successful use of standard alcohol withdrawal treatments. Conclusion: The findings of our systematic review are inconclusive. There was significant heterogeneity between and within studies. Significant publication bias is likely. Randomized control trials of more carefully delineated samples would produce evidence of greater clinical utility, for example, on differential effectiveness of antipsychotics and optimal length of standard alcohol withdrawal treatments. AIPD patients who show poor treatment responses should be studied in greater depth. Short Summary: This systematic review of alcohol-induced psychotic disorder treatment found 15 studies and 10 case reports of relevance. Older studies of first-generation antipsychotics reported full or partial remission in most patients, as did newer studies with second-generation antipsychotics. Novel drugs reported low remission rates. Standard alcohol withdrawal treatments were successful. BACKGROUND Excess alcohol consumption results in medical and social problems around the world. It accounts for 3% of global deaths (Rehm et al., 2009). Neuropsychiatric consequences to alcohol dependence syndrome include delirium tremens, alcohol-related brain damage, Korsakoff's syndrome and alcoholic hallucinosis. The terms 'alcoholic hallucinosis' and 'alcohol-induced psychotic' disorder (AIPD) are often used interchangeably, although they may be better
Alcohol-induced psychotic disorder and delirium in the general population
The British Journal of Psychiatry, 2010
Background Epidemiological data on alcohol-induced psychotic disorder and delirium (alcohol-induced psychotic syndrome, AIPS) are scarce. Aims To investigate the epidemiology of AIPS, the risk factors for developing AIPS among people with alcohol dependence, and mortality associated with alcohol dependence with or without AIPS, in a sample drawn from the general population of Finland. Method A general population sample of 8028 persons were interviewed with the Composite International Diagnostic Interview and screened for psychotic disorders using multiple sources. Best-estimate diagnoses of psychotic disorders were made using the Structured Clinical Interview for DSM–IV Axis I Disorders and case notes. Data on hospital treatments and deaths were collected from national registers. Results The lifetime prevalence was 0.5% for AIPS and was highest (1.8%) among men of working age. Younger age at onset of alcohol dependence, low socioeconomic status, father's mental health or alcohol...
Alcohol and Alcoholism, 2019
Aims: Psychotic symptoms can occur in the general population, and alcohol use disorder (AUD) is an identified vulnerability factor. However, it remains unclear how AUD is associated with psychotic symptoms, depending on the underlying psychiatric condition. We aimed to compare the prevalence of psychotic symptoms among subjects with different types of psychiatric disorders, i.e. unipolar or bipolar disorders, anxiety disorders, psychotic disorders or no psychiatric disorder, depending on whether or not there was an underlying AUD. Methods: In a 38,694-subject general population study, we compared the likelihood of occurrence of seven types of psychotic symptoms, depending on the AUD status and the underlying psychiatric disorders, after adjustment for age, sex, marital status, education and income levels. Results: In unipolar depression and anxiety disorders, almost all types of psychotic symptoms were found associated with AUD (odds ratios (ORs) between 1.98 and 2.19). In contrast, in bipolar disorder, only auditory hallucinations were associated with AUD (OR = 2.50). In psychotic disorders, only thought broadcasting was more frequent among subjects with AUD (OR = 1.78). Conclusion: Our findings in depression and anxiety disorders are in line with the 'dual diagnosis' concept, which posits that comorbid psychiatric/addictive disorders form distinctive entities that are more frequently associated with non-specific severity factors, here psychotic symptoms.
Follow-up study of alcoholic hallucinosis
Indian journal of psychiatry, 2003
Alcoholic hallucinosis is a pathological mental state characterized by an acute onset of predominant auditory hallucinations that occur either during or after a period of heavy alcohol consumption. In this study, 52 patients with a diagnosis of Psychotic disorder predominantly hallucinatory associated with alcohol use (F 10.52) were evaluated after a period of three years. Past history of withdrawal hallucinations was associated with alcoholic hallucinosis The study has found a wide spectrum of outcome confirming the earlier observations that alcoholic hallucinosis is a heterogeneous disorder.
The impact of alcohol on clinical outcomes in established psychosis: a longitudinal study
2014
Alcohol use disorders are common among people with psychosis and are associated with poorer prognoses. In psychosis patients, there are inconsistent findings regarding the link between alcohol disorders and clinical symptomatic outcomes. This study examined the relationships between alcohol consumption and specific clinical outcomes, including affective symptoms, in psychosis. Participants were recruited from secondary care services in the United Kingdom. Two hundred and ten participants whose substance use met inclusion for an alcohol disorder were compared with other substance users (n = 117) on baseline demographic, clinical and substance use variables. The alcohol subgroup was assessed at three time-points, with repeated measures of psychopathology and alcohol use over a 2-year period. Generalized estimating equations (GEE) models were used to examine whether change in alcohol use was associated with change in clinical outcomes. We controlled for a wide range of potential confounds, including other substance use. A small but specific effect was evident for change in the quantity of alcohol consumed on change in depression (adjusted coefficient for 10 total units over 90 days: 0.0015, P = 0.047). Alcohol consumption was not associated with subsequent severity of psychotic symptoms (adjusted coefficient for Positive and Negative Syndrome Scale general for 10 average daily units 0.2492, P = 0.420) or severity of anxiety symptoms (adjusted coefficient for 10 average daily units 0.0534, P = 0.473). For people with psychosis, the most detrimental effect of alcohol consumption appears to be its effect on mood. Some of this effect seems to be reversible, with drinking reduction associated with subsequent mood improvement.
Substance Use in Psychotic Individuals-Case Control Study
Substance use in Psychotic individuals, 2023
Introduction: Substance use disorder is a burdensome condition which often coexists in patients with psychiatric disorders, but are often undetected (1, 2). Addiction and psychosis both have a dopamine dysregulation-related etiology and involves experiences of dissociation from the real world (1). Patients with psychotic disorders are considerably likely and have higher rates of substance abuse when compared to other psychiatric disorders or the general population. Objective: To determine the type and severity of substance use in psychotic patients and also to compare them with controls. Method: A case control study was conducted among 33 cases and controls. All the participants were screened using Mini International Neuropsychiatric Interview (M. I. N. I) scale and WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Chi square test/ Fishers exact test was used to compare study variables among cases and controls. P value <0.05 was considered to be statistically significant. Results: Among the cases 13.6% were alcohol dependent, 18.2% were substance dependent and 16.7% were substance abusers. Among controls 7.6% were substance abusers and only 1.5% were alcohol abusers. Among the cases 3% need intensive treatment for tobacco, cannabis and 6.1% for Alcohol. Almost 19.6% need brief intervention for tobacco followed by alcohol (6.1%), sedatives (3.1%), cocaine and Amphetamine (1.5%) Conclusion: Substance dependence and abuse was observed in psychotic patients indicating the importance of timely intervention, in understanding what started first and to take necessary steps in preventing the illness and the use of substances.
Comorbidity of harmful use of alcohol in population of schizophrenic patients
Psychiatria Danubina, 2015
Numerous studies carried out during the last twenty years point to an increase of co-morbidity of harmful use of alcohole caused disorders in the population of schizophrenic patients. The results show rate of this kind of co-morbidity between 35 and 80%. The aims of the investigation are: establishing frequency of harmful use of alcohol in the patients with diagnosis of schizophrenia, observed against the population statistics data; determination of possible predictors of harmful use of alcohol in the population of schizophrenic patients (adolsecent bihevioural problems, child neuroticism); determination of heritage role in the development of the both nosologic entities and the analysis of the outcomes of harmful use of alcohol in the population of schizophrenic patients (suicide attempts, cognitive impairment). The population included 50 inpatients between 20 and 50 years, with primary diagnosis of schizophrenia. Diagnostic procedure was carried out by application: Structured clini...
Alcohol-Induced Psychotic Disorder with Suicidal Attempt: A Case Report
The Malaysian Journal of Psychiatry, 2018
Alcohol-induced psychotic disorder (AIPD) is a rare complication of alcohol abuse which is characterized by an acute onset of auditory or visual hallucinations that occur either during or after a period of heavy alcohol consumption. Other symptoms include delusions, thought disorder, psychomotor disturbances, and abnormal affect. To establish the diagnosis, one must rule out other disorders such as alcohol withdrawal delirium or other psychotic disorders. Although it is well recognised, relatively little is known about the condition. Moreover, the pathogenesis and treatment of AIPD are still unclear despite high co-morbidity with other psychiatric disorders, high re-hospitalization as well as mortality rates and suicidal behaviour. Therefore, the prognosis appears less favourable. We present a case of young man with AIPD with suicidal attempt secondary to auditory hallucination. Please click PDF below to download the full paper...