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Eur Arch Psychiatry Clin Neurosci (2013) 263:309313 DOI 10.1007/s00406-012-0374-z
ORIGINAL PAPER
High rehospitalization rate in alcohol-induced psychotic disorder
Michael Soyka Bernd Helten Marcus Cleves
Peggy Schmidt
Received: 1 June 2012 / Accepted: 26 September 2012 / Published online: 1 November 2012 Springer-Verlag Berlin Heidelberg 2012
Abstract Little is known about the prevalence and in particular the outcome of alcohol-induced psychotic disorder (AIPD). Data from hospital statistics of the BARMER GEK, one of the major health insurance companies in Germany, show a low overall prevalence of AIPD. An analysis of readmission rates for patients hospitalized for AIPD in 2005 (N = 462) and 2006 (N = 404) for the period up to 2010 revealed very high readmission rates. Only a minority of patients were without relapse [144(31.2 %) of the 2005 sample; 152 (37.6 %) of the 2006 sample]. Thus, AIPD appears to be a rare complication of the alcohol use disorder but to have an extremely high rehospitalization rate, probably indicating a more chronic course and worse prognosis than previously thought. More follow-up studies are needed to elucidate this syndrome.
Keywords Alcohol Alcohol dependence Alcohol use
disorder Alcohol hallucinosis Alcohol-induced psychotic
disorder Prognosis
Introduction
Alcohol use disorder has a lifetime prevalence of 712.5 % in most countries [1, 2]. In the US, the one-year population prevalence of alcohol use disorders was recently estimated at 4.7 % [3].
Alcohol dependence may cause many different somatic, neurological and psychiatric disorders, including psychotic disorders and accounts for 3 % of all global deaths [4]. Alcohol-induced psychotic disorder (AIPD), formerly named alcohol hallucinosis [58], is clinically characterized by predominantly verbal or visual hallucinations, fear and delusionsusually of persecution or jealousyin alcohol-dependent patients [610]. Suicidal tendencies and aggression are frequent in AIPD. In contrast to alcohol withdrawal delirium, there is no clouding of sensorium, and consecutive amnesia for the paranoid-hallucinatory syndromes and withdrawal symptoms is missing or mild. There are fewer negative symptoms, and there is less functional impairment than in schizophrenia [11].
AIPD has been widely neglected by psychiatric and addiction medicine research [10, 12, 13]. Only a handful of studies have focused on the pathophysiology and prognosis of this syndrome. Dopaminergic dysfunction has been demonstrated in alcohol use disorder [14, 15] but not in AIPD. Predisposing genetic vulnerability...