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Alcohol Abuse: How do you assess a problem?

Alcohol Abuse and Related Medical Illnesses

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Alcohol Abuse: Matching Treatment With Individuals


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Alcohol Induced Psychotic and Mood Disorders


Alcohol induced psychotic disorder:

Alcohol induced psychotic disorder is characterized by prominent hallucinations or delusions that are judged to be due specifically to the effects of alcohol. The symptoms associated with alcohol induced psychotic disorder usually occur within a month of alcohol intoxication or withdrawal, with the individual being fully alert and oriented, and usually lacking insight that these symptoms are actually alcohol induced. Although the psychotic symptoms may occur during or shortly after alcohol intoxication, delirium or alcohol withdrawal delirium, alcohol induced hallucinations, and/or delusions do not occur exclusively during the course of these conditions. Indications that hallucinations and delusions are not part of a primary psychotic episode include atypical and late age onset of psychotic symptoms, onset of alcohol drinking preceding the onset of psychiatric symptoms, and remission of psychotic episodes during extended periods of abstinence. Usually, alcohol induced psychotic symptoms have a tendency to subside within several weeks of abstinence, although in a small group of individuals, psychotic symptoms can sometimes become chronic, resulting in the need for long-term treatment with antipsychotic medication. In these circumstances, clinicians should also consider schizophrenia or delusional disorders in deciding on the relevant diagnosis for this individual in addition to alcohol induced psychotic disorder.


Alcohol induced mood disorder:

Alcohol induced mood disorders are usually characterized by a depressed mood and lack of interest in normal activities, as well as an elevated, expansive, or extremely irritable mood, which frequently develops after heavy drinking. These symptoms may occur during episodes of alcohol intoxication or withdrawal, and may resemble a primary major depressive, manic, hypomanic, or mixed episode. In contrast to the dysphoria and serious lack of energy observed during episodes of alcohol withdrawal with some individuals, the severity and duration of alcohol induced mood symptoms is much greater than what may usually be expected, resulting in the need for attention by a clinician. Although mood disturbances are very common among alcohol abusers entering treatment (occurring in up to 80% of individuals), alcohol induced mood symptoms usually tend to go away within two to four weeks following alcohol cessation. Information that would help to define that the alcohol related mood disturbances are not better explained by primary mood disorders should be sought by the clinician. Information which suggests a primary mood disorder rather then alcohol induced mood disorder, would be that the onset of the mood symptoms precede the onset of alcohol abuse, and that the mood disorders persist after alcohol cessation or during extended periods of abstinence. Regardless of whether the mood symptoms seem to be primary or secondary, given a high prevalence of suicide among alcoholics, clinicians should closely monitor the individual for emerging suicidal thoughts, and implement more intensive treatment when necessary.

From DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allan Tasman

Additional Information and webpage by Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist)

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