Altered forms of alcohol intoxication

CASE STUDY: Altered forms of alcohol intoxication

1. Patient Identification Data

Patient: M., 34 years old
Sex: Male
Education: Secondary vocational education
Marital status: Married
Occupation: Driver
Place of residence: Urban area

2. Complaints

According to relatives, after consuming a small amount of alcohol, the patient becomes suddenly aggressive and irritable, may perform impulsive actions, and remembers the episode poorly afterward.

3. Medical History

The patient has been consuming alcohol since the age of 20, initially episodically. During the last 5–6 years, alcohol consumption has become more frequent.

According to his wife, during the last two years, even after drinking a small amount of alcohol, the patient’s behavior changes sharply: unmotivated aggression, suspiciousness, and conflict behavior appear. Several fights have occurred.

One of the episodes:
After drinking 150–200 ml of strong alcohol, the patient suddenly became excited, started shouting at others, broke dishes, and attempted to hit an acquaintance. After several hours he fell asleep. The next day he remembered the events only fragmentarily.

4. Objective Status

• Consciousness: clear
• Oriented in time and space
• Mood: unstable, irritability observed
• Insight into the episodes: partially reduced

5. Preliminary Diagnosis

Altered form of alcohol intoxication (dysphoric variant).

6. Questions for Discussion

1. What forms of altered alcohol intoxication exist?
2. How does pathological intoxication differ from ordinary alcohol intoxication?
3. What factors may contribute to the development of altered forms of intoxication?
4. What is the physician’s management strategy when such conditions are identified?

7. Learning Objectives

• To learn how to recognize clinical signs of altered forms of alcohol intoxication.
• To conduct differential diagnosis between ordinary, pathological, and altered intoxication.
• To determine appropriate therapeutic and preventive strategies.

8. Possible Altered Forms of Alcohol Intoxication

• dysphoric
• paranoid
• hallucinatory
• hysterical
• epileptoid.