title: Alcohol-induced psychotic disorder: brain perfusion and psychopathology--before and after anti-psychotic treatment.
abstract: Alcohol-induced psychotic disorder (AIPD) also known as alcohol hallucinosis is a rare complication of alcohol abuse. The pathogenesis and treatment of AIPD are still unclear. Few prospective treatment studies are available but case reports generally suggest that anti-psychotic treatment is effective. Brain imaging changes in relation to treatment response have also not been studied except for case reports. The aim of this study was to investigate the effect of anti-psychotic treatment on psychopathology and regional cerebral blood flow (rCBF) in patients with AIPD before and after 6 weeks of treatment. Nineteen patients with AIPD were assessed by the Positive and Negative Syndrome Scale (PANSS) and single photon emission computed tomography (SPECT) before and after 6-weeks of open-label treatment with a fixed dose of haloperidol (5 mg/day). Highly significant improvements were noted on the positive, general and total scores of the PANSS. Post-treatment increased rCBF to the left caudate and left frontal lobe was noted. Changes in frontal, temporal, parietal, occipital, thalamic and cerebellar rCBF showed significant negative correlations with the degree of symptom improvement, suggesting dysfunction of these areas in AIPD. Psychopathological and rCBF findings suggest reversible generalised cerebral dysfunction in AIPD.
authors.affiliation: Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa. gpj2@sun.ac.za
authors.forename: Gerhard P
authors.initials: GP
authors.lastname: Jordaan
authors.forename: James M
authors.initials: JM
authors.lastname: Warwick
authors.forename: Daan G
authors.initials: DG
authors.lastname: Nel
authors.forename: Richard
authors.initials: R
authors.lastname: Hewlett
authors.forename: Robin
authors.initials: R
authors.lastname: Emsley
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000098:blood supply / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D059906:Neuroimaging; D009483:Neuropsychological Tests; D010477:Perfusion; D011599:Psychopathology; D011604:Psychoses, Alcoholic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol