Edson Mutandwa

AlcoholIt is a central nervous system depressant that slows down bodily functions, such as heart rate, pulse, and respiration.

It can cause

intoxication,

Sedation

sometimes unconsciousness.

In very large doses, alcohol can cause death

What is alcohol Misuse Alcohol misuse refers to drinking that causes mental,

physical or mental harm to an individual. However it does not include those with formal alcohol dependence.

Recognition of alcohol MisuseScreening questions

1. CAGE questionnaire-four questions

2. AUDIT-10 item structured interview

Causes of alcohol misuseGenetic factors- twin studies, higher concordance in

MZ than DZ twins with an estimated heritability of about 50%(Bienvenu et al, 2011).Also investigation of adoptee support genetic explanation

Learning factors-children following their parents drinking patterns

Psychiatric disorders

Physical complications Direct toxic effects

Often accompanied by poor diet which may lead to deficiency of proteins and B vitamins

Increase the risk of accidents

General neglect which can lead to increased susceptibility to infections

Physical complicationsGastrointestinal disorders

Liver damage

Gastritis

Peptic ulcers

Oesophageal varices

Acute and chronic pancreatitis

Physical complicationsNervous system

Peripheral neuropathy

Epilepsy

Cerebellar degenerations

Rare complications; optic atrophy, central pontinemyelinosis and Marchiafava-Bignami syndrome

Physical complicationsCardiovascular system

Hypertension

Increased risk of stroke

Other physical complications include anemia, myopathy, episodic hypoglycemia, hemochromatosis, vitamin deficiencies etc

Mental/psychiatric complications1. Intoxication phenomena

2. Withdrawal phenomena

3. Toxic or nutritional disorders

4. Associated psychiatric disorders

Mental/psychiatric complicationsIntoxication phenomena

Severity of symptoms of intoxication corellatesapproximately with the blood acohol concentration

There is much individual variation in the psychological effects of alcohol

Memory blackout or short term amnesia

Mental/psychiatric complicationsWithdrawal phenomena

Delirium tremens-occurs in people whose history of alcohol misuse extends over several years. Following alcohol withdrawal there is a dramatic and rapidly changing picture of disordered mental activity with clouding of consciousness, disorientations in time and place and impairment of recent memory.

Hallucinations, severe agitation, shouting and evidence of fear

Last for 3-4 days

Mental/psychiatric complicationsToxic or nutritional disorders

These include;

Korsakov’s psychosis

Wernicke's encephalopathy

alcoholic dementia-

Mental/psychiatric complicationsAssociated psychiatric disorders

Personality deterioration

Mood and anxiety disorder

Suicidal behavior

Pathological jealousy

Alcoholic hallucinations

Social complicationsFamily problems

Divorce

Quarrelling and violence

Abuse to the children

Children perform poorly at school and may develop emotional or behavioral disorders

Social complicationsWork difficulties

Declining efficiency

Lower grade jobs

Repeated dismissals to lasting unemployment

Crime

Fraud

Sexual offences

Crimes of violence

reference Shorter Oxford Textbook of Psychiatry: sixth edition

2012, Philip Cowen et al