Abstract
AimsThis study aimed to explore the neuro-cognitive deficits of alcohol-induced psychotic disorder as compared to the cognitive deficits of uncomplicated alcohol dependence.MethodsParticipants were recruited from the acute psychiatric admission wards of the Department of Psychiatry, University of Stellenbosch and Stikland and Tygerberg Academic Hospitals in the Western-Cape, South Africa. Participants who met DSM IV TR criteria (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC, 2000) for Alcohol Dependence and for alcohol-induced psychotic disorder, respectively, were included. Participants who met criteria for another current DSM IV TR Axis I disorder were excluded. A structured interview was done prior to neuropsychological assessment to ascertain current mental state and to obtain relevant demographic detail and history. Neuropsychological assessments were performed and supervised by clinical psychologists at either Tygerberg or Stikland Hospital.ResultsThe groups were matched demographically with similar period of abstinence prior to assessment. The alcohol-induced psychotic disorder group experienced first psychotic symptoms at age 35. The results reflected statistically significant differences on tasks measuring immediate memory; recall upon delay; exaggeration of memory difficulty and abstract thinking.ConclusionThis study concurs with earlier literature that some cognitive deficits are greater in alcohol-induced psychotic disorder compared to uncomplicated alcohol dependence.
Highlights
The understanding of alcohol-induced psychotic disorder (AIPD) as an illness phenomenon is becoming is increasingly important for the clinician
It was noted that the number of persons’ diagnosed with alcohol psychosis has escalated by four times in certain countries [2] and for patients diagnosed with AIPD there is 68% risk of re-admission [3]
The AIPD group experienced psychotic symptoms for the first time at age 35 (Table 1) suggesting a mean age of onset in the fourth decade which concurs with previous reports [1, 7]
Summary
The understanding of alcohol-induced psychotic disorder (AIPD) as an illness phenomenon is becoming is increasingly important for the clinician. AIPD is often described as a “rare complication” [1] of alcohol use disorders. Despite this description, it was noted that the number of persons’ diagnosed with alcohol psychosis has escalated by four times in certain countries [2] and for patients diagnosed with AIPD there is 68% risk of re-admission [3]. There is a 37% co-morbidity of AIPD with other mental disorders [4] and a 5–30% risk that patients with AIPD will develop a chronic schizophrenia-like syndrome [5]. Whilst AIPD resembles paranoid schizophrenia, it generally occurs without negative symptoms [1, 7]. The person suffering from AIPD related auditory hallucinations has no insight into the fact that hallucinations are substance-induced [10] especially during the episode
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