Comorbidity and therapy of affective disturbances in associated forms of alcoholism

Abstract

Comorbid pathology of brain in formation of associated forms with the second stage of alcoholism (A): with exogenous-organic brain impairment of traumatic (group I); hypertensive (II), cervicogenic (III) genesis and without comorbidity.Group I: A is formed early in persons with premorbidely problematic social adaptation (62,2% - excitable traits of character). Dysphoria in intoxication and withdrawal syndrome (AWS) results in psychopath-like degradation with total social desadaptation. Astheno-explosive modality of dysphoria - quick exhaustibility of affective oscillations. Outside AWS - reactive lability, asthenic-subdepressive states with dysphoric, hysteric-excitable components, more seldom hypochondriac manifestations.Group II: Later formation of A (26,7% - anxious personality). Psychosomatization of anxiety - neurocirculatory dystonia (NCD). Alcohol decreased level of anxiety and severity of NCD with subsequent fixing the ataractic motivation of ethanol intake. In structure of AWS anxious-phobic modality of dominating depressive disorders with cerebral-asthenic and cardiovascular manifestations of toxicogenic effects of ethanol modified development of torpid asthenic-depressive states (with cardiophobic and hypochondriac components) - formation of hypochondriac variant of remission. Clinical efficacy of antidepressant Paxil in comorbid anxious-depressive syndromes has been revealed.Group III: Intermediate tempo of alcoholism progression acceleration with obligation of diencephalic psychovegetative, psychosensory and severe psychoorganic cognitive disorders with asthenic, more seldom dysphoric variants of alteration of personality.Comorbidely-conditioned variants of pathologically altered biological ground in associated forms of alcoholism broadens approaches to systemization of clinical polymorphism of affective disturbances with therapeutic strategies individuation.