Understanding Other Alcohol-Induced Disorders
Addiction Medicine • Psychiatry • Primary Care
Understanding Other Alcohol-Induced Disorders
Alcohol use can trigger a variety of mental, behavioural, and neurocognitive disorders beyond intoxication and withdrawal. These conditions—ranging from mood and anxiety syndromes to psychosis, sleep disorders, and neurocognitive decline—require accurate recognition and timely intervention. This guide provides clinicians with essential diagnostic and management principles.
Scope
“Other Alcohol-Induced Disorders” (DSM-5) includes psychiatric or neurological conditions caused directly by alcohol’s acute or chronic effects. Symptoms arise during use, intoxication, withdrawal, or shortly after cessation, and improve as alcohol use resolves.
Types of Alcohol-Induced Disorders
- Alcohol-Induced Depressive Disorder — low mood, anhedonia, fatigue, suicidal thoughts linked to heavy drinking patterns.
- Alcohol-Induced Anxiety Disorder — panic, generalised anxiety, autonomic hyperarousal often during withdrawal.
- Alcohol-Induced Psychotic Disorder — hallucinations, delusions typically emerging during heavy use or early withdrawal.
- Alcohol-Induced Sleep Disorder — insomnia, fragmented sleep, REM rebound, and parasomnias.
- Alcohol-Induced Sexual Dysfunction — reduced libido, erectile dysfunction, delayed ejaculation.
- Alcohol-Induced Neurocognitive Disorder — memory impairment, executive dysfunction, Wernicke–Korsakoff syndrome.
Symptoms & Clinical Features
- Mood changes: irritability, hopelessness, depressed affect.
- Anxiety: restlessness, tremors, palpitations, fear of losing control.
- Psychotic symptoms: auditory hallucinations, persecutory beliefs.
- Sleep disruption: difficulty initiating sleep, vivid dreams, nightmares.
- Cognitive decline: forgetfulness, poor attention, impaired judgment.
- Neurological features: ataxia, confusion, ophthalmoplegia (Wernicke’s).
Assessment & Identification
- Obtain detailed alcohol history: frequency, quantity, pattern, last drink.
- Screen for acute withdrawal, liver disease, nutritional deficiencies.
- Identify symptom timeline — symptoms should begin during or soon after heavy use.
- Use tools: AUDIT-C, CIWA-Ar for withdrawal, PHQ-9/GAD-7 for mood/anxiety.
- Rule out primary psychiatric disorders or medical causes (thyroid issues, infections, head injury).
Treatment Principles
- Stabilise acute withdrawal where present (benzodiazepines as per protocol).
- Correct deficiencies: thiamine supplementation before glucose in suspected Wernicke’s.
- Manage psychiatric symptoms with short-term medications when necessary.
- Initiate long-term relapse prevention: acamprosate, naltrexone, disulfiram (careful selection).
- Provide structured psychotherapy: CBT, motivational interviewing, relapse-prevention therapy.
- Address comorbidities: liver disease, trauma, depression.
Red Flags — Urgent Referral Required
- Severe confusion, ataxia, or eye movement problems → suspect Wernicke’s encephalopathy.
- Psychosis with risk of harm to self/others.
- Withdrawal seizures or delirium tremens signs.
- Severe suicidality linked to alcohol use.
- Inability to maintain hydration or nutrition.
Case Example
Patient: M., 45, heavy weekend binge drinker presenting with depressive symptoms and anxiety during workdays. Symptoms improved after four weeks of abstinence with psychosocial therapy and initiation of naltrexone. No primary mood disorder diagnosed.
தமிழில் — சுருக்கம்
மது அதிகப்படியாகப் பயன்படுத்தும் போது மனநிலை மாற்றம், பயம், பித்தப்பித்திரம், தூக்கக் கோளாறுகள், நினைவாற்றல் குறைபாடு போன்ற பல மனநோய் அறிகுறிகள் தோன்றலாம். சரியான மதுபான வரலாறு, உடனடி சிகிச்சை, மற்றும் நீண்டகால புனர்வாழ்வு திட்டங்கள் மிக அவசியம்.