Alcohol addiction is a pathology that affects all spheres of human life, including his psyche. Almost everyone knows the expression "white tremens", in medicine it is called "delirium". Often, alcoholics also develop alcoholic hallucinosis, a psychosis accompanied by auditory hallucinations and delusions. But with this pathology, a person’s consciousness is not disturbed, he retains orientation in the environment and awareness of his own personality. This pathology is in second place after delirium tremens, which is often diagnosed in those who abuse alcoholic beverages.
Characteristics and description of pathology
Alcoholic hallucinosis according to ICD-10 code is F10.5. This pathology is a verbal hallucinosis, which is accompanied by a delusional idea of persecution. The disease is diagnosed in 15% of chronic alcoholics, it usually appears after forty years on the background oflong-term alcohol abuse. 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 that scold or threaten the life of the patient. These phenomena contribute to the formation of persecution mania, the appearance of severe anxiety and fear. Often a sick person tries to protect themselves from a non-existent threat by performing dangerous actions aimed at harming others and themselves.
Alcoholic hallucinosis often begins to show its first signs during a hangover. The disease usually develops after ten years of everyday drinking. 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, the code is 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 to him, characterize his actions, accuse and threaten. This form of the disease has a duration of several days, in the absence of therapy, it transforms into psychosis.
- Subacute, or prolonged, alcoholic hallucinosis is characterized by a course fromone month to six months. Pathology begins with acute hallucinosis, which is joined by other syndromes. 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, depression may develop, accompanied by anxiety and self-blame. In the third case, a sick person is dominated by delirium, fear of reprisal against him, persecution mania, adaptation disorder.
- Chronic form of pathology is rare. Usually such a disease is delayed 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 perception of extraneous sounds, which the patient perceives as real, joins the pathology. Often develop visual hallucinations, persecution mania. After two weeks, the symptoms disappear, leaving only verbal hallucinations, to which the person adapts over time. Usually voices and sounds appear with external stimuli. Delusions and mania of persecution are pronounced. Acute alcoholic hallucinosis may return with alcohol consumption.
Disease types
Depending on the symptoms in medicine, it is customary to distinguish the following types of illness:
- 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 due to the development of such disorders 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 severe anxiety, delirium practically does not develop. This type of disease is considered to be the easiest in course, which develops with a severe hangover. At the same time, a person experiences a strong fear, which sometimes degenerates into horror. A person understands the cause of hallucinations, but cannot get rid of the feeling of fear. Usually, the pathology goes away after a person sleeps well.
- Mixed alcoholic hallucinosis, in which the pathology is accompanied by other mental disorders: delirium, delirium, which are not related to auditory hallucinations.
Causes of disease development
The reasons for 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;
- long-term 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 have a neurological disease against the background of the disease.
According to numerous studies, alcoholic hallucinosis is formed against the background of encephalopathy, in which the hypothalamus is affected inthe result of a severe withdrawal syndrome.
Beginning of disease development
The 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, symptoms are accompanied by visual hallucinations, which are implausible, but have a negative impact on the patient's condition. The patient may feel like a fairy-tale hero, losing orientation in space and time, he often takes part in saving the world, in the battle with aliens.
Sometimes there is a stuporous disorder that develops against a background of psychosis. In this case, a person freezes in one place, not reacting to what is happening around, while consciousness can be clouded. The patient may remain in this state for several hours.
Symptomatics
Then, delusional ideas, persecution mania, 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 non-existent threat: he closes himself in a room, runs away from home, hides in the basement, etc. Sometimes there are suicide attempts (10 percent of cases) or harm to others.
In all other casesthe disease proceeds in a milder form, the patients remain oriented in space and time, they behave with restraint, but this state can change at any time. A feature of the disease is that with alcoholic hallucinosis, another person cannot influence the content of the patient's delirium in any way, so relatives and friends do not have the opportunity to persuade the patient to receive medical help.
Some Features
In acute abortive hallucinosis, delirium does not develop, the exit from the pathological state occurs a few days after the onset 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 disturbance, tremor, arrhythmia, 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 from such diseases as schizophrenia complicated by alcoholism, hallucinatory-paranoid form of encephalitis, Plaut's syphilitic exogenous organic hallucinosis.
A distinctive 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, while drinking alcohol or after it. Schizophrenia can occur at anytime.
Hallucinatory-paranoid form of encephalitis manifests itself in the form of neurological symptoms: hypertension, tremor, loss of movement, bradyphrenia. This is what distinguishes it from hallucinatosis.
Syphilitic exogenous organic hallucinosis proceeds slowly, the patient understands that he is ill. But in this case, other signs of syphilis appear.
Therapy of disease
Treatment of alcoholic hallucinosis is carried out in a hospital by a narcologist. Therapy includes:
- detoxification of the patient's body;
- management of negative psychotic symptoms;
- normalization of metabolic processes;
- restoring the functionality of organs and systems;
- prevention of complications.
Medicines
For detoxification, saline solutions and "Reopoliglyukin" 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 psychotic manifestations of pathology. Usually these funds are administered as injections.
The course of therapy will depend on the duration of the course of the disease. The sooner treatment is started, the soonersymptoms will be eliminated. The main condition for treatment is the complete rejection of alcoholic beverages.
In the chronic form of the pathology, the doctor prescribes antipsychotics, such as Olanzapine or Quetiapine, electric shock and even insulin coma.
Mandatory conditions for therapy
In order for the therapy to be effective, in parallel with drug treatment, a consultation with a psychotherapist is required. A person can be completely cured of alcoholic hallucinosis only when he gets rid of alcohol dependence.
Thus, no matter what form of the disease is observed in the patient, he is always prescribed:
- means to eliminate affective disorders, such as Diazepam;
- vascular drugs such as Cinnarizine;
- hepatoprotectors;
- means to eliminate metabolic disorders, such as Phenibut;
- multivitamins.
Forecasts
Usually, the prognosis of the acute form of the disease is favorable, hallucinations disappear within one month, they disappear abruptly after a person has a good night's sleep. Sometimes the symptoms subside gradually. Delirium and depression may be present for some time. Intelligence does not decrease.
In the chronic form of the disease, after the cessation of alcohol consumption, the symptoms subside or completely disappear. In this case, hallucinations can appear with severe stress, fatigue and other critical moments. Drinking alcohol will exacerbate the problem.
Prevention
Methods of prevention include maintaining a he althy lifestyle, excluding the use of alcoholic beverages for a long time, timely treatment of chronic alcoholism.
In the treatment of pathology, an important point is the prevention of relapses. A narcologist together with a psychotherapist should help a person get rid of addiction to alcohol, for this various methods are used, for example, an intramuscular implant, encoding, 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. At the first signs of the disease, it is recommended to consult a doctor.
