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Phenomenology and Course of Alcoholic Hallucinosis
Journal of Dual Diagnosis ( IF 1.5 ) Pub Date : 2019-06-04 , DOI: 10.1080/15504263.2019.1619008
Venkata Lakshmi Narasimha 1 , Rahul Patley 2 , Lekhansh Shukla 2 , Vivek Benegal 1 , Arun Kandasamy 1
Affiliation  

Abstract Objective: The objective of the study was to examine the correlates, phenomenology, and short-term treatment response to benzodiazepines and antipsychotics in an inpatient sample with alcohol-induced psychotic disorder, predominant hallucinations i.e., F10.52. Methods: We reviewed the charts of the patients admitted in a tertiary care addiction treatment center between 2010 and 2016 with the diagnosis of alcoholic hallucinosis. Results: Among 6,493 patients admitted with alcohol dependence during the study period, 61 patients (0.9%) had alcoholic hallucinosis. Among them, 41 (67.2%) had alcoholic hallucinosis in the past; 26 (42.6%) had a family history of psychosis. Only auditory hallucinations were found in 46 patients (75.4%), only visual hallucinations in 3 patients (5%), and both auditory and visual hallucinations in 12 (19.7%). Thirty-four (55.7%) had delusions, which were secondary to hallucinations. Suicidality which includes suicidal ideas and attempts was noted in 12 (19.7%) patients. Fifty-three (86.9%) patients had hallucinations exclusively during alcohol withdrawal, while 8 (13.1%) had them during withdrawal as well as while consuming alcohol. At the end of six months, 13.1% of the patients had an independent psychotic disorder diagnosed. The primary mode of management was treatment with only benzodiazepines (n = 37, 60.7%) or benzodiazepines and antipsychotics (n = 24, 39.3%). The reasons for starting antipsychotics were the presence of florid psychotic symptoms (26.2%) and incomplete symptom resolution with benzodiazepines (9.8%). The median duration of response was four days, with 25th to 75th quartile range at two to seven days. Conclusions: Alcoholic hallucinosis is an acute short-lasting psychotic disorder which lasts for less than a week when treated. Suicidality is high in this group, which needs attention. Benzodiazepines as part of withdrawal management may be sufficient for a majority of cases. Antipsychotics may be required in selected cases. A high degree of recurrence and morbidity indicates a need to intervene early with an abstinence-oriented management goal.

中文翻译:

酒精性幻觉的现象学和病程

摘要 目的:本研究的目的是检查酒精性精神病患者样本中苯二氮卓类药物和抗精神病药物的相关性、现象学和短期治疗反应,主要是幻觉,即 F10.52。方法:我们回顾了 2010 年至 2016 年在三级护理成瘾治疗中心收治的诊断为酒精性幻觉的患者的图表。结果:在研究期间因酒精依赖入院的 6,493 名患者中,61 名患者(0.9%)患有酒精性幻觉。其中,41人(67.2%)既往有酒精性幻觉;26 人(42.6%)有精神病家族史。46 例(75.4%)仅出现幻听,3 例(5%)仅出现幻视,12 例(19.7%)出现幻听和视幻。34 人 (55.7%) 有妄想,这是继发于幻觉的。在 12 名 (19.7%) 患者中发现了包括自杀想法和企图在内的自杀倾向。53 名 (86.9%) 患者仅在酒精戒断期间出现幻觉,而 8 名 (13.1%) 患者在戒酒和饮酒期间出现幻觉。在六个月结束时,13.1% 的患者被诊断为独立的精神障碍。主要的管理模式是仅使用苯二氮卓类药物(n = 37, 60.7%)或苯二氮卓类药物和抗精神病药(n = 24, 39.3%)进行治疗。开始使用抗精神病药的原因是出现了强烈的精神病症状 (26.2%) 和苯二氮卓类药物的症状消退不完全 (9.8%)。响应的中位持续时间为 4 天,第 25 到第 75 个四分位数范围为 2 到 7 天。结论:酒精性幻觉症是一种急性的、持续时间短的精神病,治疗后持续不到一周。这个群体的自杀倾向很高,需要注意。大多数情况下,苯二氮卓类药物作为戒断管理的一部分可能就足够了。在某些情况下可能需要抗精神病药。高度的复发和发病率表明需要尽早干预以禁欲为导向的管理目标。
更新日期:2019-06-04
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