SPECIFICITIES OF STATES OF WITHDRAWING ALCOHOL WITH  DELIRIUM WITH PATIENTS SUFFERING FROM DYSCIRCULATORY ENCEPHALOPATHY

doi:10.26565/2312-5675-2018-9-07

Валерій Никифорович Кузьмінов ДУ «Інститут неврології, психіатрії та наркології НАМН України»

DOI: https://doi.org/10.26565/2312-5675-2018-9-07

Keywords: alcohol dependence, state of withdrawal, dyscirculatory encephalopathy, organic mental disorders, delirium

Abstract

Psychoses in patients with alcohol dependence are in many cases polyetiologic, this is especially common in elderly people due to the accumulation of various somatoneurological pathologies. Isolation of the leading factor in the occurrence of acute psychosis in such patients in the state of alcohol withdrawal is of great practical importance for the choice of therapeutic tactics. Dyscirculatory encephalopathy can lead not only to persistent cognitive impairment, but also (under certain conditions) to cause delirious syndrome. One of these factors is alcohol dependence syndrome and the state of alcohol withdrawal. ICD – 10 permits the treatment of delirium as delirium with a mixed etiology of F05.8, this category includes patients with a severe state of alcohol withdrawal and somatoneurological pathology, which may also be an independent factor in delirious syndrome. The study examined 80 patients with dyscirculatory encephalopathy in the state of alcohol withdrawal, which were divided into 2 groups: with the state of alcohol withdrawal with delirium and delirium of mixed etiology (factor of dyscirculatory encephalopathy, which was considered a competing factor in the occurrence of delirium); all had delirious syndrome. In the study, the following research methods were used: clinical, clinical and laboratory, computed tomography (if necessary) and statistical. All patients were characterized by the presence of a diverse somatic pathology. Most often they were diagnosed with cardiomyopathy, chronic pancreatitis, polyneuritis, toxic encephalopathy. In addition, all examined had different liver pathologies. Analyzed the clinical picture in groups, especially transient psychoorganic syndrome. Established some differential diagnostic signs of the studied disorders. It has been suggested that protracted acute psychotic disorders in patients with alcohol dependence have a common clinical picture in the long-term period due to decompensation of somatic diseases.

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