Alcohol-induced psychotic disorder: a review

Abstract

While alcohol-induced psychotic disorder (AIPD) is well recognised, relatively little is known about the condition. We undertook a review of the literature to identify studies on the epidemiology, clinical manifestations, underlying neurobiology and treatment of AIPD. Few prospective studies have been conducted on AIPD. Recent advances have focussed on epidemiological, phenomenological, neuro-imaging, treatment and outcome issues. Current evidence suggests AIPD can be clinically distinguished from alcohol-withdrawal delirium and schizophrenia. The disorder may be more common than previously recognised depending on the inclusion criteria applied. AIPD is associated with high co-morbidity with other psychiatric disorders, high re-hospitalization and mortality rates and suicidal behaviour. Concurrent dysregulation of several neurotransmitter systems may be involved in the pathogenesis of hallucinations in alcohol dependence, and neuro-imaging studies suggest perfusion abnormalities to various brain regions. Antipsychotic treatment remains the preferred treatment for AIPD. The prognosis appears less favourable than previously believed, yet usually good when abstinence can be maintained.

Cognitive changes in alcohol-induced psychotic disorder

“…The AIPD group generally performed poorer on all tasks, but a statistically significant poorer performance was only recorded for tasks assessing immediate verbal memory, delayed verbal recall and abstract verbal reasoning abilities. These findings support the notion that several brain regions [15, 50] and possibly several neurotransmitter systems [6] are involved in the pathogenesis of AIPD. Of particular interest is the the perisylvian language network.…”

“…Recent research [1, 6] concurs with earlier findings [7] that AIPD is a distinct diagnostic entity that can be distinguished from schizophrenia. Most commonly, AIPD mostly occurs with auditory hallucinations but also delusions, often of a paranoid nature.…”

“…Whilst AIPD resembles paranoid schizophrenia, it generally occurs without negative symptoms [1, 7]. The psychotic episode reportedly often lasts no more than a month [8] to 6 months [6, 9], but during that time, reality testing is impaired. The person suffering from AIPD related auditory hallucinations has no insight into the fact that hallucinations are substance-induced [10] especially during the episode.…”

Alcohol and delirium tremens: effects of average number of drinks per day and beverage type

“…DT is included among the alcohol-psychoses but has its own clinically distinguishing features. 1 It often presents acutely when alcohol dependent persons reduce or discontinue their alcohol consumption. Individuals with symptoms of alcohol withdrawal have a 3-6% risk of developing DT.…”

Healthcare Utilisation, Morbidities and Alcohol Use Monitoring Prior to Alcoholic Psychosis Diagnosis

“…The lifetime prevalence of alcoholic psychosis has been estimated to approximate 0.5%-1.8% (3,4). However, in individuals who develop the disorder, there are serious health risks including an increased risk of suicidal behaviour with or without depression, and a rehospitalisation rate of up to 60% (2)(3)(4)(5). Mental and behavioural disorders due to alcohol use accounted for over 200,000…”