P-25 - Alcoholic Hallucinosis: Report of two Cases

Abstract

Starting with 2 clinical cases of alcoholic hallucinosis, the author reminds the existence of this clinical entity, first described by Wernicke, which is found in the DSM IV at the F10.52 category (“Psychotic disorder induced by alcohol, with hallucinations, starting during withdrawal”). The 2 patients, aged 43 and 23, were hospitalised in the following behavioral disturbances with self- and heteroaggressiveness. In both cases, a similar episode was found in the anamnesis.The clinical picture includes sudden onset of acoustic hallucinations after 2 days of alcohol withdrawal, within a context of chronic alcoholism. Persecutions, both mystical and of jealousy, an experience of massive anxiety, as well as a delusional belief are at the origin of acting out. Absence of a confusional syndrome, dissociative or of thymic symptomatology, normal cerebral imaging, liver disorders (cytolysis and hepatic steatosis).Although during the acute episode these phenomena seem real for the patients, during the evolution the patients display the tendency to stand aloof from them, considering them pathological and attempting to master them. The interest of this study is the perspective with the literature data of these clinical situations, infrequent in practice, but with potentially serious behavioral consequences in the acute. Producing a diagnosis allows a rather favourable outcome in the case of a well conducted treatment that takes into consideration immediate (acting out) and long term (recurrence) risks.