Shustov D.I., Kiselev D.N., Novikov S.A., Zuykova N.L.
Secondary alcohol dependence in patients with schizophrenia and organic brain damages
The article presents findings of the clinical trial aimed at the investigation of clinical characteristics of secondary alcohol dependence in patients suffering from mental disorders, as well as an impact of these characteristics on patients’ anti-alcohol help seeking and outcomes of various types of anti-alcohol treatment. The clinical examination of 108 patients (93 males and 15 females) with mental disorders combined with alcohol dependence was performed. True alcohol dependence was diagnosed in 67 people (60 males and 7 females), symptomatic alcohol dependence was diagnosed in 33 subjects (28 males and 5 females). True alcohol dependence preceded the development of schizophrenia significantly more often, and by the time of an endogenous disorder onset this dependence had reached the 2nd degree severity. It has been demonstrated that the onset of schizophrenia in 43,3% of cases with true alcohol dependence was connected with an incident of heavy drinking and was provoked by it. The evidence has been received that true alcohol dependence combined with schizophrenia has a clearly marked hereditary component and progresses quickly. Most patients with such a condition abuse alcohol on an occasional basis and develop the alcohol withdrawal syndrome with expressed somatic and mental components earlier, with psychoses occurring during the withdrawal. True alcohol dependence in the majority of cases contributes to a greater severity of schizophrenia, more frequent self-destructive behaviours, manifestations of antisocial behaviours – criminal acts resulting in conviction and regular mandatory visits to the in-patient dispensaries. At the same time true alcohol dependence is the main factor contributing to an increased anti-alcohol help seeking. The findings show that symptomatic alcoholism in the structure of a concomitant disease increases the manifestation severity of the productive symptoms of endogenous and exogenous mental disorders, leads to problems in adaptation (pathological adaptation) and socialization, which negatively influences treatment motivation.
Key words: alcohol dependence, schizophrenia, organic brain damage.
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