Psychiatric complications of alcoholism: Alcohol withdrawal syndrome and other psychiatric disorders

Instituto de Educação Continuada, PUC Minas, FATEC, Minas Gerais, Brazil.
Revista Brasileira de Psiquiatria (Impact Factor: 1.77). 06/2004; 26 Suppl 1:S47-50.
Source: PubMed


Alcohol withdrawal syndrome is an acute condition secondary to total or partial reduction of alcohol consumption, characterized by self limited signs and symptoms and different degrees of severity. It can be complicated by several clinical and/or other psychiatric related problems. The objective of this article is to review the most important psychiatric complications to alcohol withdrawal syndrome as well as other psychiatric disorders associated with alcohol dependence as Wernicke Korsakoff and Marchiava Bignami syndromes. We aim to promote early diagnosis and treatment of these conditions, minimizing morbidity and mortality associated with them.

Download full-text


Available from: Florence Kerr-Correa, Dec 13, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Delirium is defined as an impairment of counsciousness and cognitive functions and is a common cause of disturbed behaviour in many patients with different somatic diseases and mental disorders. Most at risk are elderly, postoperative patients, critically ill patients and those with cancer in advanced stages. In psychiatric intensive care units patients with alcohol and sedative withdrawal related delirium are more often treated. Although delirium is a negative prognostic indicator leading to higher morbidity and mor- tality of patients, it often goes undetected and poorly managed. Conclusions Most recommendations for management of delirium are based on the nonpharmacologi- cal supportive care and prevention of delirium. It is also necessary to identify and treat the underlying causes. Antipsychotics are the mainstay of symptomatic pharmacological treatment and have been shown to be effective in treating symptoms of both hyperactive and hypoactive delirium. Although efficacy rates between typical and atypical antipsychotic agents are similar, the later are associated with fewer extrapyramidal side effects. Benzo- diazepines are usually preferred for withdrawal delirium or as an alternative or adjuvant to antipsychotics when these are ineffective or cause unacceptable side effects.
    Preview · Article ·
  • [Show abstract] [Hide abstract]
    ABSTRACT: The cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.
    No preview · Article · Dec 2011
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to test seeking behavior caused by alcohol and the drug effects on learning in the zebrafish, Danio rerio. Three treatments were conducted: acute, chronic and withdrawal, using 0.10%, 0.25%, 1.00% alcohol and control (0.00%) (vol/vol%). For the drug seeking behavior, we used a place preference paradigm (shuttle box tank) before and after alcohol exposure in acute (single exposure) and chronic (7days) treatments. We observed a change in the basal preference due to the association with alcohol only for 0.25% and 1.00% doses in both acute and chronic offering, indicating an alcohol-seeking behavior after the drug exposure. For the learning task, two treatments were tested: chronic alcohol exposure (26days including the learning period) and alcohol withdrawal (15days of alcohol exposure before the learning period). During the learning period, fish received light stimulus followed by food in a pre-defined area of the tank for 8 consecutive days. The low dose group (0.10%) learned the task by the 3rd day both in chronic and withdrawal treatments. The higher doses (0.25% and 1.00%) caused a learning impairment in the chronic treatment group, while fish from the alcohol withdrawal treatment displayed learning on the final testing day. Therefore, we suggest that high alcohol doses impair learning and cause drug seeking behavior, even after drug exposure cessation, while low doses positively affect learning and do not cause seeking behavior. Given our results we propose that the zebrafish is a promising model for identifying active compounds, antibodies or genes which modulate the alcohol dual effects: learning improvement and reinforcing behavior.
    Full-text · Article · Mar 2014 · Progress in Neuro-Psychopharmacology and Biological Psychiatry