Alcoholic hallucinosis – metalkogolny psychosis, the second for prevalence, after delirium tremens. Can sharply proceed, or chronically. Usually acoustical hallucinations prevail, the nonsense in most cases develops. Unlike alcoholic the deliriya remains orientation in the world around and own personality. Consciousness is not broken. At height of hallucinations and crazy frustration attempts of a suicide and infliction of harm to people around are possible. Hospitalization, neuroleptics, soothing apply, vitamins, means to improvement of a metabolism in a brain and medicines for correction of somatic violations.
Alcoholic hallucinosis – one of the most widespread metalkogolny psychoses. Develops at 5-11% of the patients having chronic alcoholism. Usually arises 40 years against the background of the constant long-term use of alcohol are aged more senior. Women suffer more often than men. Depending on a form can proceed from several days to one year and more. The main difference from alcoholic the deliriya is prevalence of acoustical hallucinations, and also preservation of orientation in surrounding and own personality.
Acoustical hallucinations are perceived as absolutely real voices which abuse the patient or threaten to do him heavy harm (to cripple, kill, rape). Against the background of these voices of the patient alcoholic hallucinosis can hear shouts of the children or the wife begging about the help. Everything listed promotes formation of nonsense of prosecution, emergence of the expressed concern and fear. The patient can begin to be protected from nonexistent enemies. Socially dangerous actions, infliction of harm to relatives and suicide attempts are possible. Urgent hospitalization under observation of experts in the field of narcology and psychiatry is necessary.
Reasons of development and classification of alcoholic gallyutsinoz
The long systematic use of high doses of alcohol is the reason of development of alcoholic gallyutsinoz. As a rule, the disease arises at patients with an experience of chronic alcoholism of 10-15 and more years. At 54% of patients the second stage of alcoholic dependence, is diagnosed for 46% - the third. At all patients neurologic pathology comes to light. At this kind of psychoses lower tolerance to alcohol is observed, than at alcoholic deliriya. There are researches confirming that hallucinosis develops against the background of alcoholic encephalopathy with damage of a hypothalamus. Pathological changes in a brain are aggravated owing to an abstinence syndrome. It is noted that before psychosis abstinency at many patients proceeds heavier, than usually.
Distinguish sharp, subsharp and chronic alcoholic gallyutsinoza. Taking into account features of a current and the prevailing symptomatology allocate:
- Classical or typical gallyutsinoza – are followed by multiple true acoustical hallucinations. The nonsense represents interpretation of hallucinations. Patients feel the expressed fear.
- The reduced gallyutsinoza – acoustical hallucinations gipnagogichesky (arise at the time of falling asleep) or simple, scrappy. The crazy concept, as a rule, is not formed or is insufficiently created. Affective violations in the form of alarm, depression and fear are observed.
- Atypical gallyutsinoza – against the background of acoustical hallucinations arise uncharacteristic violations: consciousness obscurings, stupor, mental avtomatizm etc. Prevalence of affective frustration is possible.
- The mixed gallyutsinoza – the hallucinosis combination to other mental disorders is observed (for example, with deliriy or with the nonsense which is not connected with acoustical hallucinations).
Symptoms of alcoholic hallucinosis
Typical sharp alcoholic hallucinosis begins suddenly. Within several days before emergence of the first symptoms of a disease harbingers and a type of the increased uneasiness, fear, distrustfulness and internal tension can be observed. Typical acoustical hallucinations prevail. The patient hears voices which tell about him something unflattering, condemn, abuse or threaten. Can seem to the patient that these voices proceed from walls, objects surrounding people or from where from the outside.
Sometimes acoustical hallucinations are supplemented with optical illusions which never happen such bright and plausible as at alcoholic deliriya, however have the negative effect, supplementing a picture of the patient "occurring" in creation. Against the background of hallucinations the crazy ideas are formed (usually – the relations or prosecutions). The patient can consider that someone is going to subject him to painful tortures, to beat to death, it is cruel to kill him and his immediate family etc.
Level of alarm and fear at the patient having alcoholic hallucinosis is similar to the level of alarm and fear which the ordinary person endures at emergence of direct real threat for own life. Patients try to be protected from "danger" somehow: barricade in the room, run away from the city, hide in garages or at dachas etc. At emergence of deliriozny obscuring of consciousness (it is observed at 10% of patients) the attempt of a suicide or desperate protection with drawing serious damages to people around is possible.
In other cases orientation in the world around is kept, patients behave rather frostily, but it does not give a reason to assess a situation as safe as their state at any time can change. Besides, at alcoholic hallucinosis, unlike alcoholic a deliriya, other people cannot influence in any way the maintenance of nonsense of patients therefore relatives or emergency doctors in case of aggression lose an opportunity to persuade patients and to find some acceptable explanation for need "peacefully" to receive medical care.
Sharp abortive gallyutsinoza differ from classical in poorly expressed small hallucinations. The crazy ideas are not formed. An exit comes from psychosis sharply in several days after an onset of the illness. At chronic hallucinosis the nonsense usually is absent. In the beginning sharply there are menacing, disturbing acoustical hallucinations (it is frequent – in a combination with visual). In the subsequent intensity of hallucinations decreases and patients get used to them. If the nonsense nevertheless arises, it differs in smaller absurd and better gives in to correction.
Treatment and the forecast at alcoholic hallucinosis
Treatment is performed by the narcologist in the conditions of a narcological hospital. The plan of therapy includes an intensive detoxication, elimination of the psychotic phenomena, exchange normalization, restoration of functions of bodies and systems, and also the prevention of development of permanent cognitive violations. In the course of a detoxication use , a haemo misinformation and salt solutions. To patients appoint group B vitamins, cocarboxylase, inosine and ascorbic acid. Apply piracetam, ethylmethylhydroxypyridine to prevention of brain violations and meldoniya Medicines for correction of somatic pathology select taking into account the violations revealed at the specific patient.
For knocking over of the psychotic phenomena at sharp hallucinosis use , a haloperidol, , etc. Medicines usually enter parenterally, is more rare – orally. Speed of disappearance of hallucinations directly depends on prescription of the beginning of psychosis. The earlier treatment is begun, the psychotic symptoms are stopped quicker. At chronic gallyutsinoza apply neuroleptics, an electroshock and an insulin coma. In all cases an indispensable condition of successful treatment is the full refusal of alcohol.
The forecast at sharp gallyutsinoza favorable. Usually hallucinations remain from several days to 1 month, and then sharply come to an end after a deep sleep. Gradual fading of symptomatology is less often observed. For some time the residual nonsense can remain, the depression sometimes develops (more often at women). Intellectual decrease does not occur. At chronic gallyutsinoza the termination of alcohol intake causes reduction or disappearance of hallucinations. In the subsequent hallucinations can arise only at the critical moments (at strong fatigue, high level of a stress etc.). Alcohol intake provokes an aggravation of symptoms of hallucinosis. Even at a long current intellectual safety is usually observed.