Psychosis and Alcohol Abuse: Which Psychiatric Treatment for the Patient?

At present the patients with dependency on psychoactive substances, complicated psychological pathology when alcoholism and drug addiction are combined with different types of personal disorders, depression and psychosis,... [ view full abstract ]

At present the patients with dependency on psychoactive substances, complicated psychological pathology when alcoholism and drug addiction are combined with different types of personal disorders, depression and psychosis, occupy a significant place in the clinical psychiatric practice. Conjugacy of two disease developing simultaneously influences on the clinical picture of each of them and presents a huge diffential-diagnostic and therapeutic complications.

The aim of the current research was to develop a treatment program addressing patients with psychosis and alcohol abuse. In our psychiatric hospital the program included a therapeutic element with a weekly Therapeutic Group for patients focusing on the problems with alcohol abuse. The patients were treated by group psychotherapy during 5 weeks by two sessions per week. They were additionally offered individual psychotherapy once a week.

Results. In total 84 patients, 69 males, 15 females, were examined. The age of patients fluctuated between 18 and 66, an average being 38,9±10,6 years. 72 patients were diagnosed with schizotypical disorder combined with alcoholism, in 12 cases chronic alcohol intoxication (symptomatic alcoholism) was observed. The appearance of early symptoms of psychiatric disease in most patients preceded beginning of alcohol abuse. In the clinical picture of the patients under research, the dominant features were affective disorders such as depression, anxiety, anguish, decrease in activity, loss of interest in outside world, apathy and autistic behavior.

Conclusion. During the therapeutic process of present program we have observed significant improvement in the affective field as well as the behavior of examined patients. However, findings of the study will be a subject to further studies. This program has specially been designed to enable true hospitalization at the psychiatric hospital for comorbid patients. It also enhances the sense of competence of psychiatric caregivers facing these comorbid disorders.