Alcohol-Related Psychosis

Excerpt

Alcohol-related psychosis (ARP) is a well-established complication of heavy alcohol use, although poorly understood. The association between alcohol use and psychosis was first recognized by Claude Marcel in 1847 when he described a case series of patients with folie d'ivrogne ("drunken madness"). In addition to this early term, this phenomenon has been called "alcohol insanity," "Kraepelin's hallucinatory insanity of drunkards, "Wernicke's acute hallucinosis of drunkards," and "alcohol hallucinosis." The most current terminology used for this condition is alcohol-induced psychosis or ARP.

ARP is a distinct entity from other withdrawal syndromes, eg, delirium tremens, Wernicke's encephalopathy, Korsakoff's psychosis, and alcohol-induced dementia , with the latter being caused by chronic alcohol use associated with nutritional deficiencies (eg, thiamine). Additionally, while delirium tremens is a severe withdrawal feature , ARP and primary psychiatric conditions, eg, schizophrenia, can be similar, and ARP may result from the unmasking of preexisting psychiatric disease or occur in conjunction with a psychiatric disorder. All these entities share alterations in cognitive awareness and delusions and may involve auditory, tactile, or sometimes visual hallucinations. The classically taught diagnosis of ARP is known as alcohol hallucinosis, a relatively rare consequence of alcohol use that occurs as a result of withdrawal.