Skip to main content
×
×
Home

Alcohol-induced psychotic disorder and delirium in the general population

  • Jonna Perälä (a1), Kimmo Kuoppasalmi (a1), Sami Pirkola (a1) (a2), Tommi Härkänen (a3), Samuli Saarni (a1) (a2), Annamari Tuulio-Henriksson (a1), Satu Viertiö (a1), Antti Latvala (a1), Seppo Koskinen (a4), Jouko Lönnqvist (a1) (a2) and Jaana Suvisaari (a1) (a5)...
Extract
Background

Epidemiological data on alcohol-induced psychotic disorder and delirium (alcohol-induced psychotic syndrome, AIPS) are scarce.

Aims

To investigate the epidemiology of AIPS, the risk factors for developing AIPS among people with alcohol dependence, and mortality associated with alcohol dependence with or without AIPS, in a sample drawn from the general population of Finland.

Method

A general population sample of 8028 persons were interviewed with the Composite International Diagnostic Interview and screened for psychotic disorders using multiple sources. Best-estimate diagnoses of psychotic disorders were made using the Structured Clinical Interview for DSM–IV Axis I Disorders and case notes. Data on hospital treatments and deaths were collected from national registers.

Results

The lifetime prevalence was 0.5% for AIPS and was highest (1.8%) among men of working age. Younger age at onset of alcohol dependence, low socioeconomic status, father's mental health or alcohol problems and multiple hospital treatments were associated with increased risk of AIPS. Participants with a history of AIPS had considerable medical comorbidity, and 37% of them died during the 8-year follow-up.

Conclusions

Alcohol-induced psychotic disorder is a severe mental disorder with poor outcome.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Alcohol-induced psychotic disorder and delirium in the general population
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Alcohol-induced psychotic disorder and delirium in the general population
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Alcohol-induced psychotic disorder and delirium in the general population
      Available formats
      ×
Copyright
Corresponding author
Jonna Perälä, National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, PO Box 30, 00271 Helsinki, Finland. Email: jonna.perala@thl.fi
Footnotes
Hide All

Declaration of interest

None.

Footnotes
References
Hide All
1 Somers, JM, Goldner, EM, Waraich, P, Hsu, L. Prevalence studies of substance-related disorders: a systematic review of the literature. Can J Psychiatry 2004; 49: 373–84.
2 World Health Organization. Global Status Report on Alcohol 2004. WHO, 2004.
3 Hiroeh, U, Kapur, N, Webb, R, Dunn, G, Mortensen, PB, Appleby, L. Deaths from natural causes in people with mental illness: a cohort study. J Psychosom Res 2008; 64: 275–83.
4 Glass, IB. Alcohol hallucinosis: a psychiatric enigma – 1. The development of an idea. Br J Addict 1989; 84: 2941.
5 Glass, IB. Alcohol hallucinosis: a psychiatric enigma – 2. Follow-up studies. Br J Addict 1989; 84: 151–64.
6 Caton, CL, Drake, RE, Hasin, DS, Dominguez, B, Shrout, PE, Samet, S, et al. Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Arch Gen Psychiatry 2005; 62: 137–45.
7 Tsuang, JW, Irwin, MR, Smith, TL, Schuckit, MA. Characteristics of men with alcoholic hallucinosis. Addiction 1994; 89: 73–8.
8 Schuckit, MA, Tipp, JE, Reich, T, Hesselbrock, VM, Bucholz, KK. The histories of withdrawal convulsions and delirium tremens in 1648 alcohol dependent subjects. Addiction 1995; 90: 1335–47.
9 Victor, M, Adams, RD. Effects of alcohol on the nervous system. Res Publ Assoc Res Nerv Ment Dis 1953; 32: 526–73.
10 Soyka, M. Prevalence of alcohol-induced psychotic disorders. Eur Arch Psychiatry Clin Neurosci 2008; 258: 317–8.
11 Soyka, M. Prevalence of delirium tremens. Am J Addict 2008; 17: 452.
12 Aromaa, A, Koskinen, S (eds). Health and Functional Capacity in Finland: Baseline Results of the Health 2000 Health Examination Survey. National Public Health Institute, 2004.
13 Wittchen, HU, Pfister, H. DIA-X-Interviews: Manual für screening-verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIAX-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12 Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung). [DIA-X Interviews: Manual for Screening and Interview; Interview book for longitudinal assessment (DIA-X-Lifetime); Supplementary book (DIA-XLifetime); Interview book for cross-sectional assessment (DIA-X-12 months); Supplementary book (DIA-X-12 months); PC-Program for performing the interviews (longitudinal and cross-sectional assessment); Analysis program.] Swets & Zeitlinger, 1997.
14 Kendler, KS, Gallagher, TJ, Abelson, JM, Kessler, RC. Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample: the National Comorbidity Survey. Arch Gen Psychiatry 1996; 53: 1022–31.
15 Perälä, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsä, E, Pirkola, S, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 2007; 64: 1928.
16 First, MB, Anthony, JC, Tepper, S, Dryman, A. Structured Clinical Interview for DSM–IV Axis I Disorders, Research Version, Nonpatient Edition (SCID–I/NP). Biometrics Research, New York State Psychiatric Institute, 2001.
17 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM–IV–TR). APA, 2000.
18 Mathias, S, Lubman, DI, Hides, L. Substance-induced psychosis: a diagnostic conundrum. J Clin Psychiatry 2008; 69: 358–67.
19 Pirkola, SP, Isometsä, E, Suvisaari, J, Aro, H, Joukamaa, M, Poikolainen, K, et al. DSM–IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population: results from the Health 2000 Study. Soc Psychiatry Psychiatr Epidemiol 2005; 40: 110.
20 Organisation for Economic Cooperation and Development. The OECD List of Social Indicators. OECD, 1982.
21 Mäkelä, P. Alcohol-related mortality as a function of socio-economic status. Addiction 1999; 94: 867–86.
22 Research Triangle Institute. SUDAAN Language Manual, Release 9.0.0. Research Triangle Institute, 2004.
23 Lehtonen, R, Pahkinen, EJ. Practical Methods for Design and Analysis of Complex Surveys (2nd edn). Wiley, 2004.
24 Therneau, T, Grambsch, P. Modeling Survival Data: Extending the Cox Model. Springer, 2000.
25 Babor, TF, Stenius, K, Romelsjo, A. Alcohol and drug treatment systems in public health perspective: mediators and moderators of population effects. Int J Methods Psychiatr Res 2008; 17 (suppl 1): 50–9.
26 Kendler, KS. A twin study of individuals with both schizophrenia and alcoholism. Br J Psychiatry 1985; 147: 4853.
27 Hrubec, Z, Omenn, GS. Evidence of genetic predisposition to alcoholic cirrhosis and psychosis: twin concordances for alcoholism and its biological end points by zygosity among male veterans. Alcohol Clin Exp Res 1981; 5: 207–15.
28 Moos, RH, Brennan, PL, Mertens, JR. Mortality rates and predictors of mortality among late-middle-aged and older substance abuse patients. Alcohol Clin Exp Res 1994; 18: 187–95.
29 Achté, K, Seppälä, K Ginman, L, Colliander, N. Alcoholic Psychoses in Finland. Finnish Foundation for Alcohol Studies, 1969.
30 Lehtonen, ML. Alkoholipsykoosipotilaan Ennuste. Seurantatutkimus Alkoholipsykoosiin Sairastuneista Miehistä. [The outcome of alcohol-induced psychotic disorder – a follow-up study of men with alcohol-induced psychotic disorder.] Tampere University, 1996.
31 Lindelius, R, Salum, I. Mortality. Acta Psychiatr Scand Suppl 1972; 235: 8699.
32 Coleman, MP, Quaresma, M, Berrino, F, Lutz, JM, De Angelis, R, Capocaccia, R, et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol 2008; 9: 730–56.
33 Arendt, M, Rosenberg, R, Foldager, L, Perto, G, Munk-J⊘rgensen, P. Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. Br J Psychiatry 2005; 187: 510–5.
34 Arendt, M, Mortensen, PB, Rosenberg, R, Pedersen, CB, Waltoft, BL. Familial predisposition for psychiatric disorder: comparison of subjects treated for cannabis-induced psychosis and schizophrenia. Arch Gen Psychiatry 2008; 65: 1269–74.
35 Merikangas, KR, Stolar, M, Stevens, DE, Goulet, J, Preisig, MA, Fenton, B, et al. Familial transmission of substance use disorders. Arch Gen Psychiatry 1998; 55: 973–9.
36 Cook, BL, Winokur, G. Separate heritability of alcoholism and psychotic symptoms. Am J Psychiatry 1985; 142: 360–1.
37 Jaffee, SR, Moffitt, TE, Caspi, A, Taylor, A. Life with (or without) father: the benefits of living with two biological parents depend on the father's antisocial behavior. Child Dev 2003; 74: 109–26.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
PDF
Supplementary materials

Perälä et al. supplementary material
Supplementary Table S1-S2

 PDF (43 KB)
43 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 86 *
Loading metrics...

Abstract views

Total abstract views: 718 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 28th May 2018. This data will be updated every 24 hours.

Alcohol-induced psychotic disorder and delirium in the general population

  • Jonna Perälä (a1), Kimmo Kuoppasalmi (a1), Sami Pirkola (a1) (a2), Tommi Härkänen (a3), Samuli Saarni (a1) (a2), Annamari Tuulio-Henriksson (a1), Satu Viertiö (a1), Antti Latvala (a1), Seppo Koskinen (a4), Jouko Lönnqvist (a1) (a2) and Jaana Suvisaari (a1) (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *