The harm of alcohol to the human body is mainly due to alcohol, which is an anesthetic, a neurophilic substance, and has an important impact on the central nervous system. Alcoholism is very serious in some countries and has become an important social problem, and it has also been on the rise in China in recent years. Alcoholism is caused by long-term or heavy drinking of alcohol to form a Xi to form paralysis. Damage to the central system can lead to the development of psychiatric symptoms, which are divided into acute and chronic categories.
Usually so-called drunkenness is a mental disorder caused by acute alcoholism, that is, the so-called "drunken madness", which is manifested as emotional excitement, increased speech, easy to excite, loss of control, and unsteady walking, slurred speech, etc., which is called ordinary drunkenness, which is more common.
Another type of psychiatric disorder caused by acute alcoholism, in which small amounts of alcohol can cause severe psychiatric symptoms, manifested by confusion with intense excitatory and aggressive behavior, or fragmentary hallucinations and delusions that last for minutes and hours. Mental disorder in chronic alcoholism is a serious damage to the central nervous system caused by long-term drinking, manifested by gradually worsening personality changes and mental declineThe patient becomes selfish, withdrawn, sluggish, lacks a sense of social responsibility, does not care about his family, is emotionally unstable, irritable, has slow thinking, memory loss, mental decline, has a strong and uncontrollable intention to drink, in order to get alcohol by unscrupulous means, tremors and delirium can occur, vivid hallucinations or delusions of jealousy, and often accompanied by serious lesions of various internal organs.
Pathogenesis. Alcohol is a fat-soluble, neurophilic substance, has a direct neurotoxic effect on the human brain, can increase the permeability of the blood-brain barrier, resulting in serious damage to the central nervous system, and has an inhibitory effect on the central nervous systemBrain atrophy
Long-term heavy alcohol consumption can lead to dementia, and although the pathological mechanism is not well understood, most believe that the main causes are the neurotoxic effects of alcohol and thiamine deficiency. Both the neurotoxic effects of alcohol and thiamine deficiency can reduce neuronal activity and interfere with neurotransmitter synthesis, release, and reuptake. Both can also cause damage to the basal ganglia nucleus, resulting in reduced synthesis of certain neurotransmitters, such as acetylcholine and norepinephrine. Memory impairment in patients with chronic alcohol-toxic mental disorders may be associated with a decrease in acetylcholine: when acetylcholine is significantly reduced, it can also developDementia
Onset**. 1.Genetic factors
Survey data confirm that the familial clustering of alcoholism is very significant. The more severe the parent's alcoholism, the greater the risk of their child suffering from the same disease. Individuals with first-degree relatives who are alcohol-dependent have twice as many problems with alcohol consumption as those without this genetic history. This also happens in individuals who have second-degree, ** relatives who are alcohol-dependent. The study also found that individuals with conduct disorders, depression, and high neuroticism,** novelty-seeking, extroverted individuals had a significantly increased risk of inherited alcohol dependence.
2.Biochemical abnormalities
Alcohol can cause abnormalities in the function of the dopamine (DA) system in certain areas of the brain. The results showed that the administration of DA antagonists to experimental animals could cause an increase in alcohol craving, and chemical damage to DA neurons could also enhance the animal's foraging behavior. The above study suggests that experimental animals need to consume alcohol to compensate for the lack of function of DA. Other studies have reported that alcohol craving is associated with serotonin (5-HT) system abnormalities. The contents of serotonin (5-HT) and its metabolite 5-hydroxyindoacetic acid (5-HIAA) in the frontal cortex, striatum and hippocampus of alcoholophilic rats were significantly lower than those in the control groupImmunostaining showed a decrease in the number of 5-HT neurons in alcoholic mice.
3.Socio-environmental factors
Studies suggest that factors such as values, social Xi customs, social roles, economic development, dietary Xi habits, and social stress are closely related to alcohol-induced mental disorders. Many patients have tried to relieve stress and anxiety by drinking alcohol before becoming ill, thus promoting the reinforcement of drinking behavior. Both domestic and international studies have found that the following social factors are more related to drinking-related problems: male gender, low education level, marriage breakdown, heavy physical labor, social tolerance for drunken people, low income, etc.
4.Psychological factors
Studies of patients with alcoholism have found that other psychiatric disorders often coexist with alcoholism. Nearly 80% of patients with alcoholism have at least one other psychiatric disorder, with depression, anxiety, and personality disorder being the most commonConversely, patients with depression, anxiety, or personality disorder often drink heavily. The above results suggest that the relationship between alcohol-induced mental disorders and other mental disorders is difficult to determine and may be causal to each other.
Alcohol dependence syndrome.
This is a special psychological state caused by repeated drinking, the patient has a craving for alcohol and a compulsive feeling of constant need to drink, which can occur continuously or intermittently, and if the drinking is stopped, the symptoms of psychological and life withdrawal appear. The syndrome has several clinical features:
Uncontrollable cravings for alcohol;
A fixed drinking pattern in which the patient must drink at a fixed time regardless of the occasion in order to avoid or alleviate withdrawal symptoms
Drinking alcohol has become so central to the point that it has a significant impact on work, family life and social activities
Tolerance increases gradually, and patients need to increase the amount of alcohol they drink in order to achieve the initial results of drinking or to prevent physiologic withdrawal symptoms
Withdrawal syndrome occurs repeatedly, and if the patient reduces the amount of alcohol consumed or prolongs the interval between drinks, it causes the alcohol concentration in the body to drop and the withdrawal syndrome occurs. The most common symptoms are tremors of the hands, feet, limbs, and trunk, ataxia, irritability, and easy startle reactionsExcessive sweating, insomnia, nausea, and vomiting may also be seen.
Delirium tremens
Temporary disturbance of consciousness can occur soon after a sudden reduction in alcohol consumption or cessation of alcohol consumption after a long period of drinking. At the time of the attack, the patient is unconscious, has temporal and local disorders, and has vivid and vivid visual hallucinations and delusions of victimizationThis manifests as extreme fear, restlessness, or impulsive behavior. At the same time, the patient's limbs are coarse, tremor, and ataxia, often accompanied by fever, sweating, tachycardia, increased blood pressure, and mydriasis. In severe cases, it can be life-threatening. Delirium tremens vary in duration, generally 3 to 5 days. After recovery, the patient partially or completely forgets about the condition.
Hallucinosis
It is a state of hallucinations caused by long-term alcohol consumption. The patient has a large number of rich and vivid hallucinations within 1 to 2 days after suddenly reducing or stopping drinking, and the hallucinations are predominant. Primitive visual hallucinations are common, as well as critical and commanding auditory hallucinations. On the basis of hallucinations, fragmentary delusions and corresponding nervousness, fear, or depression may also occur. During the onset of the disease, the patient's state of consciousness is clear, and there are no obvious symptoms of psychomotor excitement and autonomic neurological hyperfunction.
Paranoia
Delusions of jealousy and delusions of victimization occur in patients with clear consciousness, and the former is more common in clinical practice. Patients have unfounded suspicions of infidelity on their spouses, for which they often have a violent reaction, which can also lead to attacks on the object of suspicion or the spouse, sometimes resulting in bad results. In the past, it was also called alcohol toxicity jealousy.
Encephalopathy
This is the most serious psychotic state of chronic alcohol poisoning, which is the result of organic brain damage caused by long-term heavy drinking. Delirium, memory loss, dementia and personality changes are the main clinical features, and the vast majority of patients cannot completely return to normal.