During an alcoholism, normally not earlier, than later 5 years after appearance of a hungover syndrome, originate diverse on the manifestations and duration psychoses. Some of them have the closest ratio 2 a syndrome of a hang-over and depend first of all on a toxicosis. It is a delirium tremens, an alcoholic hallucinosis, alcoholic depression, an alcoholic epilepsy, an alcoholic paranoid, a jealousy delirium tremens. Other psychoses are linked to violation of a swap of vitamins. These are alcoholic encephalopathies.
The delirium tremens (delirium tremens) originates normally against a hang-over, at sudden termination of drunkenness or in the abstention season, in cases of apposition of somatopathies, injuries (specially fractures). Initial symptoms of a psychosis are aggravation of a night sleep, appearance of vegetative symptoms and a tremor, and also the common vivacity of the patient marked in its movements, speeches, a facial expression and specially mood. Throughout short time it is possible to mark the most various shades of mood while in the season of a hungover syndrome the mood is uniform, it is defined by depression and alert. Unusual changeover of mood and common vivacity strengthen by the evening and at night while in the afternoon these disorders are sharply diminished and EVN can disappear absolutely, that allows the patient to fulfil the professional responsibilities. At increase of symptoms of a psychosis there is the complete sleeplessness against which one at first there are visual illusions, and then various hallucinations and delirium. 4 a delirium tremens typically predominance of the true visual hallucinations. They are defined by multiplicity of modes and movability. They are hexapods (bugs, cockroaches, beetles, flies) and fine animal (grapnels, rats, mice) more often. Less often patients C large animals and people in some cases having fantastic appearance. Visions of snakes, devils, and also the died relatives, so-called vage dead persons are very characteristic. In one cases visual illusions and hallucinations are unit, in others - mnozhestvenny and stsenopodobny, i.e. the patient C the difficult patterns. Acoustical, tactile, olfactory hallucinations, feels of violation of a rule of a skew field in room are quite often marked. Mood of patients extremely izmenchivo. In him in turning of short time it is possible to mark pavor, complacency, bewilderment, surprise, despair. Patients are routinely continuously propelled, their facial expression is indicative. Motor reactions match to hallucinations overtopping at present and affect - at pavor and frightening visions of the patient hides, defended, actuated; in the complacency seasons - it is passive. It is characteristic marginal otvlekaemost patients on the choronomic events, all ambient draws their ATTN. Brad at alcoholic deliriums is sketchy and mirrors hallucinative disorders. Under the contents it more often a persecution complex. Patients are routinely falsely oriented in a place (being in hospital, SPK, that they at home, at restaurant, at job), but oriented in the characteristic person. 4 a tremens characteristicly periodic temporary extinction of a considerable proportion of mental disorders, so-called ljutsidnye - light - intervals, and also regularly expressed magnification of symptoms of a psychosis 2NITE and at night. The delirium tremens is permanently escorted by diverse somatic disorders - jitter, a sharp sweating, a hyperemia of cutaneous coverings, specially faces. Temperature more often the subfebrile. Sphygmus is become frequent. In urine often there is a protein; in blood - the heightened contents of bilirubin, a deviation to the left, the ROE speed-up. Disease routinely short-term. EVN W / O treatment psychosis symptoms disappear within 3-5 days. Less often illness is tightened for 1-1,5 weeks. Recuperation is more often watched in the form of crisis - after a deep sleep. Sometimes recuperation gradual, W aggravation in night both night hours and enriching in the afternoon. The tags indicating the adverse prognosis of a delirium tremens, developing of symptoms of a professional and mussitans delirium, a heat, kollaptoidnye statuses are. Alcoholic galljutsnnoz it is advanced or at a hungover syndrome, or at the altitude a drinking-bout. The main disorder - the plentiful auditory hallucinations combining W a persecution complex. Verbal auditory hallucinations prevail, and the patient normally hears the words "said" by major number of people, - "chorus of voices", by frequent definition of patients. There is a talk of "voices" among themselves ABT the patient more often, less often they are addressed 2 the patient. The contents of verbal hallucinations - the threats, convicting arguing of past acts of the patient, cynical abuse, revilings. Quite often hallucinations have is humiliating-teasing nature. Voices that strengthen before cry decay before whisper. Crazy ideas under the contents closely related with auditory hallucinations - a so-called hallucinative delirium. They are sketchy and nesistematizirovany. The affect of intense alert and pavor prevails. In the beginning of a psychosis patients dvigatelno are actuated, but soon there is some dormancy or rather sequenced behaviour masking a psychosis is watched. Last creates false and dangerous submission ABT status enriching. As a rule, psychosis symptoms strengthen in a night and night time. Somatic disorders, an ordinary hang-over 4 a syndrome are constant. Duration of an alcoholic hallucinosis from 2-3 days about several weeks, in rare instances illness is tightened B4 several MTH. Alcoholic depression occurs always against a hang-over syndrome. It is defined by podavlenno-disturbing mood, ideas of self-abasement, tearfulness, and also separate ideas of the ratio and persuit. Duration - from several days till 1-2 weeks. In a status of alcoholic depression alcoholics commit suicide more often. The alcoholic epilepsy is symptomatic and is linked to toxicosis appearances. Attacks originate more often at the altitude intoxications in a hungover syndrome or during a tremens. As a rule, epileptiform attacks are marked. Small attacks, twilight stupefactions, auras at an alcoholic epilepsy does not happen. W termination of abuse by alcohol attacks disappear. Alcoholic paranoid - an alcoholic psychosis which one main symptom is the delirium. Originates in a status of a syndrome of a hang-over and at the altitude a drinking-bout. The contents of crazy ideas is reached by persuit or jealousy (ideas of matrimonial incorrectness). In case of the former patients consider, that there is a bunch of people wishing them to plunder or slay. In gestures, acts and words of associates they C confirmation of the thoughts. Bewilderment, the intense alert often succeeded by pavor is characteristic. Acts of patients have impulsive nature - they jump off on the move from a carrier, are suddenly launched in flight, access behind the help to public authorities, sometimes commit offences on envisioned enemies. In some cases the delirium is escorted by not plentiful verbal illusions and the hallucinations, the separate delirious symptoms arising in a night and night time. Flow of this form of a paranoid routinely short-term - from several days about several weeks. Occasionally the psychosis proceeds MTH. The jealousy delirium tremens (matrimonial incorrectness) originates almost exclusively for men, as a rule, after 40 years, is advanced gradually. In the beginning the patient marks, that the WF began to concern to it inattentively, and in due course is simple W hostility. Even more often, in its judgement, it shows coldness in intimate relations and EVN is simply skewed from them. Simultaneously it seems to it, that the WF starts to monitor more carefully the external appearance, tries to try to look younger, even more often somewhere leaves, permanently everywhere is delayed, and having come home, looks unusually revived and confused. The alcoholic is rasping, we will excite, is violent, requires explanations that involves all become frequent scandals. However the behaviour of a WF "is only aggravated". Suspicions ABT incorrectness, in the beginning vague and arising in connection with zapojnymi statuses, become in due course determined and stationary values. The patient approves, that the WF changes to it normally W somebody from men of the proximate surrounding - young relatives, flatmates or to the dwelling. If in the beginning "changes" are committed out of the dwelling in due course the WF "becomes impudent" and indulges in "debauchery" more narrow in the dwelling unit. The patient starts to monitor a WF, in some cases accesses behind the help to government bodies and can EVN apply pertaining to WFs violent operations. With the course of time at proceeding drunkenness of the patient starts to SPK that the WF changed to it in the past, till a marriage, and that children AAM were born not from it, and from other men. The jealousy ford can accept chronic flow W periodic peakings. Alcoholic encephalopathies - the alcoholic psychoses advanced in connection with violations of a swap and first of all of vitamins of bunch In and PP. Alcoholic encephalopathies originate owing to the perennial alcoholism escorted by a chronic gastritis or an enteritis and, as consequence of last, absorption violation in an intestine. Alcoholic encephalopathies are advanced predominantly for those faces which one drink much, but eat very little. More often alcoholic encephalopathies originate in vernal and first summer MTH. Them conditionally divide on acute and chronic. Between them there are no sharp transitions. The most frequent form of acute alcoholic encephalopathies - encephalopathy Gaje-Vernike. Has started more often gradual, 2-3 months, less often proceed more. There is a building up asthenia in which one prevail wilt, an emaciation in a combination to dysmnesias. It is reduced, and then appetite completely disappears, the night sleep is baffled, diarrheas and vomitings, headaches and giddinesses, loss of equilibrium, a polyneuritis appearance are a little bit less often advanced. In the subsequent the complete pattern of illness is advanced. Originating psychoses represent the erased and not organised delirious patterns more often, is more rare - disturbing-crazy statuses. After some days - two-three weeks after appearance of psychotic violations - mental condition starts to be determined or symptoms of an apathetic stupor, or oglushennostju, transferring in whom. W / O treatment disease is ended by mors more often. Neurologic disorders are constant and great. From vegetative symptoms violations of cordial pace, a fever of a central parentage, breath violation, wilt of sphincters are normally marked. Permanently it is possible to watch muscle tone rise. Sharply hypersensitivity 2 a pain, e.g. 2 nyxes. Are frequent diverse a hyperkinesia. Appearance of a paralysis of oculomotor muscles, a photophobia, a nystagmus normally SPK about the maximum stage of illness. Always it is possible to reveal various on intensity and localisation of an appearance of a polyneuritis. Common physical condition of patients is defined by a progressing weight loss up to a sharp cachexia. Cutaneous coverings of an acyanotic or dark-brown coloration. To chronic forms of an alcoholic encephalopathy concern korsakovsky a psychosis and an alcoholic pseudoparalysis. In one cases they are advanced by degrees, during a number of MTH and then on nature of the beginning match entssfalopatii Gaje-Voriike, in others - acutely, after alcoholic psychoses, as a rule after a delirium tremens. The Korsakovsky psychosis appears memory violations: the patient stores nothing from current events or stores it is not enough; the retrograde amnesia, false memories - the confabulations concerning daily events are marked. Last can be expressed in a various degree, sometimes miss. Patients are flaccid, passive, do not show concern to the surrounding. Voice and motor reactions are leant. From neurologic disorders meet various on intensity of an appearance of a polyneuritis more often. Disease lasts MTH, sometimes years. At drunkenness termination enrichings are possible. The alcoholic pseudoparalysis is defined by a dementia W the expressed fluctuations of memory, loss of the gained knowledge and skills, deep violations of an opinion, extinction of consciousness of illness and criticism. The mood hum noise is determined by carelessness and in some cases ideas of greatness. Storage disorders in a combination to confabulations sometimes prevail. It is adrift analogous korsakovskomu to a psychosis. Treatment of alcoholic psychoses. Patients W alcoholic psychoses are necessary for seating urgently in special hospital. Statsionirovaniju some patients W a hang-over syndrome come under also when mental disorders, specially changes in sentiments, are intensive. Treatment of alcoholic psychoses in hospital should be complex - application of Polyvitaminums (В1, W, RR), cordial and hypnagogues W hypoglycemic and comatose doses of insulin or psychothrone (aminazine, Haloperidolum) tools. A single effective remedy of treatment alcoholic, specially acutely flowing past, entsefalonaty is therapy by high doses of vitamins: B1 - B4 600 mg, W - B4 1000 mg, Rr-to 300-400 mg a day within 2-4 weeks. Zapojnoe drunkenness (dipsomania) originates for the faces, not suffering affliction an alcoholism. The drinking-bout is preceded by podavlenno-irritable mood, the impossibility to be engaged in customary businesses, sometimes a sleeplessness, headaches, appetite loss. 4 "relief" of a status of the patient starts to drink. Despite receptions of large doses of alcohol (B4 1 l a day and more), intoxication symptoms are insignificant often. Attacks last from several days about several weeks. During a drinking-bout there can be a pathological tendency 2 vagrancy (dromomania). Sudden - the patient AOTS notes the drinking-bout terminal, that for it the need for alcohol has disappeared. Can occur 2 it and disgust. Between the drinking-bout seasons the complete forgoing of alcohol is marked. The dipsomania is manifestation ipilopsii, disorders of mood for psychopathic persons, sick of schizophrenia and a circular psychosis more often. During a drinking-bout it is necessary to route the patient to an insane hospital. Pathological intoxication represents the twilight stupefaction arising routinely after receptions of insignificant doses of alcohol - 50-150 g; is one of forms of exclusive statuses. Physical symptoms of intoxication miss - movements of patients are exact and confident, a gait firm, speech clear, operations are serial and attentions of associates can not attract at all in themselves. However often under the influence frightening hallucinations and the crazy ideas escorting dulled consciousness, patients commit dangerous to themselves and surrounding acts of violence. In these cases propulsion and voice drive can be marked. Pathological intoxication proceeds from several minutes till several o'clock. It is ended by a deep sleep after which one the patient badly remembers or at all does not remember, that to it descended. Pathological intoxication is advanced more often for sick of an epilepsy, organic diseases of a brain (an injury, an arteriosclerosis), for erethitic psychopaths. Developing of pathological intoxication is contributed by overfatigue, a status of recuperation after the patient and, physical attrition, an organism overheating. The consulting of the psychiatrist is indispensable.
