Alcoholic hallucinosis: symptoms, characteristics, causes and treatment

Psychotic symptoms are the main characteristic of this disorder.

The chronic consumption of certain addictive substances, or the suspension of such consumption, can originate different alterations or mental disorders. These are organic disorders, which also appear due to organic diseases or the consumption of certain medications or drugs.

In this article we will learn about an organic disorder caused by the suspension of alcohol intake in alcoholic patients (originated by the abstinence syndrome to the substance). It is alcoholic hallucinosis. We will know what it consists of, its symptoms, characteristics (how it manifests itself, how long it lasts...), causes and treatment.

• Recommended article: "The 9 types of drug addiction and their characteristics".

Alcoholic hallucinosis: what does it consist of?

Alcoholic hallucinosis is an organic disorder that produces psychotic symptoms, and is caused by a sudden cessation or reduction of alcohol consumption in alcoholic patients who used to drink large amounts of alcohol, and for a long time. In other words, it is a disorder typical of withdrawal syndrome in alcoholics (although it can also appear due to alcohol intoxication).

This type of disturbance is considered an acute alcohol-induced disorder, and is actually part of another, more global disorder, the so-called uncomplicated (alcohol) withdrawal syndrome. This syndrome includes, in addition to alcoholic hallucinosis, other symptoms, such as: seizures, delirium, occupational delirium, and an organic hallucinosis (different from the one discussed in this article).

Symptoms

Typical symptoms of alcoholic hallucinosis are hallucinations, which are usually persistent, auditory and vivid in character. They usually appear within 48 hours after the last drink of alcohol consumed by the patient. Let's see exactly what they consist of below.

1. Hallucinations

The hallucinations of alcoholic hallucinosis are of a threatening nature. They appear in the first moments of the alteration (remember: this type of disorder usually appears in the first 48 hours after having stopped drinking alcohol). These hallucinations are usually auditory, consisting of basic or elementary (i.e., not very elaborate) sounds.

These sounds include buzzing, clicking, crackling, etc., and the patient relates them to himself. However, as alcoholic hallucinosis progresses, the sounds may become increasingly elaborate and complex, translating into threatening words or phrases, for example.

Visual hallucinations may also occur in alcoholic hallucinosis, although they are less frequent than auditory hallucinations.

But what is the content of hallucinations in this disorder? They are usually vivid and greatly disturbing to the patient, causing high levels of anxiety and distress.

2. Delusions

On the other hand, depending on the content of the hallucinations caused by alcoholic hallucinosis, the patient may elaborate delusional interpretations, the patient may elaborate delusional interpretations or delusions in order to "justify" or "understand" the presence or logic of the hallucinations.

These delusions often take the form of intense persecutory ideas, as well as ideas of influence. The patient may react to them by running away or assaulting others, for example. This often requires hospitalization of the patient to contain and compensate him/her because he/she is in a psychotic break.

This is because the patient may attempt to injure himself (self-aggressiveness) or others (heteroaggressiveness), or even attempt suicide, as a result of previous hallucinations and delusions, which he interprets and experiences as if they were real.

3. Other symptoms: anguish and irritability

There are two other typical symptoms that accompany the hallucinations of alcoholic hallucinosis: these are anguish and irritability. Thus, the patient can be irritable and irascible, annoyed by anything, and even manifest aggressive behaviors easily.

To this is added the aforementioned anguish, produced especially by the threatening hallucinations and by the uncertainty and uneasiness that these generate.

Another characteristic of alcoholic hallucinosis is that there is no clouding of the patient's consciousness, i.e., the patient's state of consciousness remains intact. In addition, there is no loss or reduction of intellectual capacity.

Characteristics

As for the general characteristics of alcoholic hallucinosis, it usually appears at the age of 40, it usually appears at about 40 years of age. However, it can also appear earlier, at 20 or 30 years of age.

On the other hand, patients with alcoholic hallucinosis usually have a history of alcohol consumption of at least 10 years' duration. That is to say, there is a previous excessive consumption of the substance, of long duration.

Onset

The onset is usually sudden (abrupt). Typical symptoms in the initial phase of alcoholic hallucinosis are: irritability, anguish and threatening auditory hallucinations.

Duration

Alcoholic hallucinosis usually lasts between days and weeks (acute forms of the disorder), depending on the amount of alcohol that used to be ingested and other variables, as we will see in the section on its causes. When it lasts several months, we speak of subacute forms. This disorder can become chronic.

Causes

As we have seen, alcoholic hallucinosis is caused by a suspension of alcohol intake. In other words, it is a substance-induced disorder, specifically alcohol (its reduction or cessation). It is a characteristic symptom of alcohol withdrawal syndrome.

Alcoholic hallucinosis can last for days or even several weeks, and although it is initially an acute disorder, it can become chronic; all this depends on the usual dose taken by the alcoholic patient, his or her previous history of addiction, personal and genetic characteristics, etc.

Treatment

Regarding the treatment of alcoholic hallucinosis, when it appears, hospitalization of the patient is recommended so that he/she can stabilize. It is also important to treat the underlying addiction (alcoholism) through specific drugs through specific drugs that promote the patient's detoxification, in order to avoid the recurrence of alcoholic hallucinosis.

Although treatment is important, prevention is also important in this disorder. Some preventive guidelines include drinking alcoholic beverages only in small doses and accompanied by food intake. Ideally, protein-rich foods should be taken, as they slow down the absorption of alcohol. This will help alcohol not to irritate so much the central nervous system and therefore the health.

On the other hand, remission of alcoholic hallucinosis occurs with long-term abstinence from alcohol. If the underlying alcohol addiction that is causing this disorder is not properly treated, relapses (relapses) may occur.

In this sense, complications can occur, and it is known that if hallucinosis extends up to 6 months or more in time, it can eventually lead to organic dementia, delirium tremens or even a paranoid schizophrenic disorder.

Bibliographical references

• Berrios, G. Organic disorders in psychiatry. In Fuentenebro, F., Vázquez, C. (1990). Medical psychology, psychopathology and psychiatry. Interamericana McGraw-Hill, Madrid.

• Grau, A. Exogenous or organic disorders. In Vallejo, J. (1991). Introduction to psychopathology and psychiatry. 3rd edition. Masson-Salvat, Madrid.

• Ruiz, Mario Martínez; Ros, Antonio Aguilar; Valladolid, Gabriel Rubio (2002-04). Manual de drogodependencias para enfermería. Ediciones Díaz de Santos.