Alcohol Symposium - Mental Health Flashcards
There are 4 sort of “diagnoses” of alcoholism:
- Acute Intoxication
- Harmful Use
- Dependence
- Withdrawal State
What is harmful use?
A pattern of use leading to physical or mental health damage over 1 month or repeatedly over 12 months
What is required to diagnose Dependence on alcohol?
3+ of the following criteria over 1 month or repeatedly over 12 months:
- Craving/compulsion
- Difficulty controlling use
- Primacy
- Tolerance
- Withdrawal
- Persistance despite harmful consequences
Define the Withdrawal State?
A cluster of symptoms that vary in presentation/severity, occurring when a substance is withdrawn after persistant use
What are the symptoms of Withdrawal?
Tremor Weakness N& V Anxiety Seizures Confusion Agitation Death
A more “severe” form of withdrawal can also occur, called?
DTs
Delirium Tremors
Typically occurs 2-3 days into the withdrawal symptoms
What are Delirium Tremors?
Profound:
- Tremor
- Confusion
- Agitation
- Hallucination
- Delusion
- Sleepiness
- Autonomic Overactivity
What are the big risks of DTs?
They can lead to death in several ways:
- CV collapse
- Infection
- Hyperthermia
- Seizure
- Self-injury
List some of the major mental health problems that can be related to alcohol use?
Anxiety Depression Sleep disruption Self-harm / suicide Morbid Jealousy Alcoholic Hallucinosis
Main treatment for all of them is Abstinence
What is Wernicke’s encephalopathy?
A condition that can occur due to thiamine deficiency in alcoholics
What causes Wernicke’s Encephalopathy?
Thiamine Deficiency from:
- Poor Nutrition
- Poor absorption (due to alcohol damage to gut)
- Poor hepatic function
- Use of thiamine for alcohol metabolism
How does Wernicke’s Encephalopathy present?
Typically with a triad (or mix) of: - Confusion - Opthalmoplegia - ataxia & Nystagmus
Wernicke’s Encephalopathy is bad enough on it’s own, but why is it so important we treat it as early as possible?
It can progress to Korsakoff’s Psychosis which can be very disabling and permanent
What does Korsakoff’s psychosis do?
Impairs recent & remote memory, both anterograde & retrograde (although it leaves immediate recall)
+ Impaired learning & disorientation
sometimes nystagmus & ataxia
What screening tools can we use looking for an alcohol problem?
- CAGE questions (2+ = likely)
- AUDIT (Alcohol Use Disorders Identification Test)
- FAST = smaller version of AUDIT for use in A&E
- PAT - Paddington Alcohol Test (also used in A&Es etc)
