Alcohol addiction is the pathology that affects all spheres of human life, including his psyche. Almost everyone knows the expression "delirium tremens", in medicine it is called "delirium". Often alcoholics also develop alcoholic hallucinosis - psychosis, accompanied by auditory hallucinations and delirium. But with this pathology, a person’s consciousness is not disturbed, he retains orientation in the environment and self-awareness. This pathology is in second place after delirium tremens, which is often diagnosed in those who abuse alcohol.
Characterization and description of the pathology
The ICD-10 alcohol hallucinosis code has F10.5. This pathology is a verbal hallucinosis, which is accompanied by the delusion of persecution. The disease is diagnosed in 15% of chronic alcoholics, usually it appears after forty years against the background of prolonged abuse of alcohol. Women are more susceptible to pathology than men.
The disease can last from two days to one year or more. In this case, the person retains orientation in space, the perception of his own personality, but auditory hallucinations develop, which are perceived as real voices, scolding or threatening the patient's life. These phenomena contribute to the formation of persecution mania, the emergence of strong anxiety and fear. Often, a sick person tries to defend himself against a nonexistent threat by performing dangerous actions aimed at harming others and himself.
Often, alcoholic hallucinosis begins to show the first signs during a hangover. The disease usually develops after ten years of drinking everyday. This condition requires immediate hospitalization.
Forms of pathology
In medicine, it is customary to distinguish the following forms of the disease depending on their course:
- Acute alcoholic hallucinosis (according to ICD-10 code indicated above) is characterized by a violation of the emotional background, depressed mood, then there is a feeling of fear, auditory hallucinations. The patient hears voices that speak with him, characterize his actions, accuse and threaten. This form of the disease lasts several days; in the absence of therapy, it transforms into psychosis.
- Subacute, or protracted, alcoholic hallucinosis is characterized by a course from one month to six months. Pathology begins with acute hallucinosis, to which other syndromes join. In some cases, delirium and anxiety do not develop, the patient is aware of his illness, but he has affective disturbances and auditory hallucinations. In another case, the development of depression is possible, accompanied by anxiety and self-accusations. In the third case, a sick person is dominated by delirium, fear of reprisal against him, persecution mania, and disorder of adaptation.
- A chronic form of pathology is rare. Usually, such a disease drags on for many years. In medicine, two subspecies of pathology are distinguished. In the first case, chronic alcoholic hallucinosis develops without delirium, there is unreasonable anxiety. Over time, the pathology is joined by the perception of extraneous sounds, which the patient perceives as real. Often develop visual hallucinations, persecution mania. After two weeks, the symptoms disappear, only verbal hallucinations remain, to which the person adapts over time. Usually voices and sounds appear with external stimuli. Pronounced delirium and persecution mania. When drinking alcohol, acute alcoholic hallucinosis may return.
Types of disease
Depending on the symptoms in medicine, it is customary to distinguish the following types of disease:
- Classic alcoholic hallucinosis. The disease is accompanied by a large number of auditory hallucinations, which develop into delirium and severe fear. This phenomenon is usually observed in the evening.
- The atypical appearance is caused by the development of disorders such as a disorder of consciousness, stupor, affective disorders that occur against the background of auditory hallucinations.
- Reduced hallucinosis is characterized by the appearance of hallucinations at the time of falling asleep, a person experiences fear and intense anxiety, and delirium practically does not develop. This type of disease is considered to be the easiest course, which develops with a severe hangover. At the same time, a person experiences intense fear, which sometimes degenerates into horror. A person understands the cause of hallucinations, but can not get rid of a sense of fear. Usually, the pathology disappears after a person has a good night's sleep.
- Mixed alcoholic hallucinosis, in which pathology is accompanied by other mental disorders: delirium, delirium, which are not related to auditory hallucinations.
Causes of the disease
The causes of the development of this disease include:
- prolonged use of alcoholic beverages, the course of alcoholism in the period from ten to fourteen years, especially among women;
- prolonged regular intoxication with ethyl alcohol.
Pathology develops in 54 percent of cases with alcoholism of the second stage, in 46 percent of cases - with the third. All patients on the background of the disease have a neurological disease.
According to numerous studies, alcoholic hallucinosis is formed against a background of encephalopathy, in which the hypothalamus is affected as a result of severe withdrawal syndrome.
The beginning of the development of the disease
Symptoms of alcoholic hallucinosis appear suddenly. This disease is preceded by severe anxiety, fear, internal stress of a dependent person. Then auditory hallucinations appear in the form of unflattering statements, condemnation, abuse and threats against the victim. It seems to a person that these voices come from surrounding objects or people.
In some cases, visual hallucinations join the symptoms, which are implausible, but have a negative effect on the patient's condition. A patient can feel like a fairy-tale hero, losing orientation in space and time, he often takes part in saving the world, in a battle with aliens.
Sometimes stuporous disorder is observed, which develops against the background of psychosis. In this case, a person freezes in one place, without reacting to what is happening around him, and consciousness may be blurred. In this state, the patient may be several hours.
Symptomatology
Then delusions, delusions of persecution, join the symptoms of pathology. At the same time, the level of fear and anxiety increases several times, a person begins to defend himself against a nonexistent threat: he closes in a room, runs away from home, hides in the basement, etc. Sometimes there are attempts at suicide (10 percent of cases) or harm to others.
In all other cases, the disease proceeds in a milder form, patients retain orientation in space and time, they behave with restraint, but this condition can change at any time. A feature of the disease is that with alcoholic hallucinosis, another person can not affect the patient’s delirium in any way, so relatives and friends do not have the opportunity to persuade the patient to receive medical care.
Some features
In acute abortive hallucinosis, delirium does not develop, the way out of the pathological condition occurs several days after the development of the disease. In the chronic form of the disease, delirium is observed, patients eventually get used to auditory hallucinations and do not pay attention to them.
Sometimes hallucinosis is manifested by the same symptoms as delirium tremens. A person has panic attacks, sleep disturbances, tremors, arrhythmias, and hypertension. Such signs can appear at any time, but most often they develop at night.
Differential diagnosis
The diagnosis is made by a narcologist. Regardless of the form and type of pathology, it must be differentiated with diseases such as schizophrenia complicated by alcoholism, the hallucinatory-paranoid form of encephalitis, and syphilitic exogenous-organic hallucinosis of Plaut.
A distinguishing feature of schizophrenia from hallucinosis is the fact that in the second case, the pathology develops at a clearly defined time: in the evening or at night, during or after drinking alcohol. Schizophrenia can occur at any time.
The hallucinatory-paranoid form of encephalitis manifests itself in the form of neurological symptoms: hypertension, tremor, loss of motion, bradyphrenia. This distinguishes it from hallucinosis.
Syphilitic exogenous-organic hallucinosis is slow, the patient realizes that he is sick. But in this case, other signs of syphilis also appear.
Disease therapy
Treatment of alcoholic hallucinosis is carried out in a hospital by a narcologist. Therapy includes:
- detoxification of the patient's body;
- relief of negative psychotic symptoms;
- normalization of metabolic processes;
- restoration of the functionality of organs and systems;
- prevention of complications.
Medicines
For detoxification, salt solutions and Reopoliglukin are used. The doctor also prescribes vitamin complexes, ascorbic acid, "Inosine". To prevent the development of disorders in the brain, nootropic drugs are used, for example, Piracetam, Meldonium. For the treatment of somatic disorders, drugs corresponding to pathologies are used.
Haloperidol, Risperidone, Azacyclonol and other drugs from this group will help eliminate the psychotic manifestations of the pathology. Typically, these agents are administered by injection.
The course of therapy will depend on the duration of the course of the disease. The sooner the treatment has been started, the faster the symptoms disappear. The main condition for treatment is a complete rejection of alcohol.
In a chronic form of pathology, the doctor prescribes antipsychotics, for example, Olanzapine or Quetiapine, electroshock and even insulin coma.
Mandatory treatment conditions
In order for the therapy to be effective, a consultation with a psychotherapist is required in parallel with drug treatment. A person can be completely cured of alcoholic hallucinosis only when he gets rid of alcohol dependence.
Thus, regardless of what form of the disease is observed in the patient, he is always prescribed:
- remedies for the elimination of affective disorders, such as Diazepam;
- vascular preparations, such as Cinnarizine;
- hepatoprotectors;
- drugs to eliminate metabolic disorders, such as "Phenibut";
- multivitamins.
Forecasts
Usually, the prognosis of the acute form of the disease is favorable, hallucinations pass within one month, they disappear sharply after a person has a good night's sleep. Sometimes the symptomatology fades away gradually. Delirium and depression may be present for some time. The level of intelligence does not decrease.
In the chronic form of the disease, after stopping the use of alcohol, the symptoms subside or completely disappear. In this case, hallucinations can occur with severe stress, fatigue, and other critical points. Alcohol intake will exacerbate the problem.
Prevention
Prevention methods include maintaining a healthy lifestyle, eliminating the use of alcoholic beverages for a long time, and timely treatment of chronic alcoholism.
In the treatment of pathology, an important point is the prevention of relapse. A narcologist, together with a psychotherapist, should help a person get rid of addiction to alcohol; for this, various techniques are used, for example, an intramuscular implant, coding, and others.
Particular attention in the treatment of pathology is paid to ensure that it does not become chronic, since it is much more difficult to treat and the prognosis will be unfavorable. If the first signs of the disease appear, it is recommended to consult a doctor.