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Alcohol- Related Psychosis: Background, Pathophysiology, Epidemiology. Frequency. United States.
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Roughly 3% of persons with alcoholism experience psychosis during acute intoxication or withdrawal. Approximately 1. 0% of patients who are dependent on alcohol and are in withdrawal experience severe withdrawal symptomatology, including psychosis. Twins studies have shown concordance rates for alcohol- related psychosis to be 1. The most commonly reported substance is cannabis (5. This causes an Antabuse- like reaction involving facial flushing and palpitations.
Studies of the Soviet Slavic Republic of Belarus from 1. Studies on alcohol consumption and psychosis are easier to study in Belarus as they are among highest consumers of alcohol in the world, with an annual consumption of 1. The presence of alcohol- related psychosis is a serious indicator of medical, neurological, and psychosocial complications that can hinder appropriate treatment and lead to negative outcomes. The prognosis for alcohol- related psychosis with treatment is considered good, with only 1. Alcohol- related psychosis itself does not have specific morbidity or mortality; instead, it correlates with a cluster of risk factors that indicate higher morbidity and mortality in patients with alcoholism. The potential for violence also exists.
Alcohol- related psychosis that does not remit with abstinence may indicate undiagnosed schizophrenia or other psychotic disorders. The use of alcohol may potentiate or initiate psychosis through kindling, a process where repetitive neurologic insult results in greater expression of the disease.
Substance abuse is a major contributing factor to the outcome and course of treatment in mentally ill patients with psychosis. The prevalence is up to 8. With intoxication, mortality is associated with the alcohol level in the blood. A blood alcohol level (BAL) greater than 4. L in nontolerant individuals can result in lethal respiratory arrest. Symptoms of visual, auditory, and tactile hallucinations are indicative of late- stage withdrawal (3. Neurologic abnormalities clear in 2.
Wernicke- Korsakoff syndrome who receive treatment with thiamine and who abstain from consuming alcohol. Irish males who traditionally drink to the point of intoxication are at higher risk, while Jewish males who traditionally shun intoxication have lower risks. Considering the relationship of thiamine to Wernicke- Korsakoff syndrome, cultures that have a low intake of thiamine and high rates of alcohol abuse also are at higher risk for the complication of Wernicke- Korsakoff syndrome. Sex. Alcohol abuse and dependency has a male- to- female ratio of 5: 1.
Females develop alcohol- related disorders later in life because they start heavy use later than males. Age. Alcohol- related psychosis occurs after extended periods of alcohol abuse that result in an alteration of neuronal membranes, genetic expression, and thiamine deficiency. Early- onset alcoholism results in a greater chance of complications earlier in life and an outcome that is influenced by psychosocial function. Late- onset alcoholism only delays the onset of complications. As a general rule, alcohol- related psychosis occurs more frequently in older populations. Most alcohol- related disorders have an onset in persons aged 3.