This syndrome occurs either during heavy drinking or on withdrawal and is characterized by paranoid psychosis without the tremulousness, confusion, and clouded sensorium seen in withdrawal syndromes.
The patient appears normal except for the auditory hallucinations, which are frequently persecutory and may cause the patient to behave aggressively and in a paranoid fashion
Aetiology
Alcoholic hallucinosis follows abrupt abstinence from prolonged excessive use of alcohol.
Clinical features
Symptoms include auditory illusions and hallucinations, frequently accusatory and threatening; the patient is usually apprehensive and may be terrified by the hallucinations and vivid frightening dreams.
The syndrome resembles schizophrenia but thought is usually not disordered, and the history is not typical of schizophrenia.
Symptoms do not resemble the delirious state of an acute organic brain syndrome as much as does delirium tremens or other pathologic reactions associated with withdrawal.
Consciousness remains clear, and the signs of autonomic lability seen in delirium tremens are usually absent.
When hallucinosis occurs, it generally precedes delirium tremens.
Treatment:
Hallucinosis is usually transient.
Recovery usually occurs in 1 to 3 wk; recurrence is likely if the patient resumes drinking
