A clinical case of mood-induced alcohol dependence

Abstract

Background: Stress-related mental disorder, or mental group disorder caused by emotional reasons, is also known as borderline disorder in psychiatry. Many physical and mental disorders can be caused and relapsed by stress. From the perspective of mental disorders, stress is the primary cause. As alcohol addiction and mood disorders are among the most common diseases among the population, a combined disorder was discovered due to increased alcohol consumption caused by stress. We chose this case since it is important to solve the diagnosis, differential diagnosis and treatment problems. Aim: A differential diagnosis of stress-related disorders and alcohol-related disorders is made, and treatment is planned. Purpose: The purpose of this study is to confirm the clinical diagnosis of stress-related mental illness, determine the level of alcohol consumption, and determine the relationship between stress-related disorder and alcohol dependence. Materials and Methods: An informed consent form was obtained from the physician to participate in the study, which was conducted using a qualitative research method. Case report: A 42-year-old woman. This is the 4th time she has been hospitalized at the National Mental Health Center. Current problem: In patients’ words: Poor sleep, feeling unwell, sometimes feeling like dying. I often feel like sighing and don’t have appetite. I have lost more than 10 kg in the last six months. She drinks a small amount of alcohol at home when she is in a bad mood. In the husband’s words: Lately, her temper gotten worse, angry all the time and she drinks alcohol alone at home. Does not care about the family. Poor sleep. She says that I got jealous and turning crazy. According to past psychiatric history: from 2018 to November 2022, she was hospitalized with the diagnosis of mood-induced adjustment disorder, delusional schizophrenia, alcohol-induced delirium, and depression-anxiety syndrome. Since the onset of the disease, she has been suffering from anxiety and discomfort in her body, so she underwent tests such as electrocardiogram, MRI of the brain, ultrasound of internal organs, ultrasound of the thyroid and breast, but no changes were found. On the advice of an internal doctor and a friend, she was admitted to the National Mental Health Center and her condition improved. Problems during the last hospitalization: In the words of the husband: She gets furious, demands alcohol, and scolds the children. She refused to go home and sit outside, so they called the police and made her admit. A diagnosis of alcohol-induced delirium was made after 21 days of treatment in her 4th hospitalization. Discussion: Physical and emotional problems caused the patient to undergo diagnostic tests in 2021-2022, but no changes were found. She improved when she was treated in a psychiatric hospital with low-dose sedatives, sleep-enhancing drugs, and psychoactive antidementia drugs. She appears to be suffering from a mental disorder based on that. In other words, in the case of mood-induced mental disorders, symptoms of synestopathy dominated by body pains or arousal changes due to excitation of the autonomic nervous system are more common, but these problem are not confirmed by diagnostic tools. Conclusions: Domestic violence is a form of severe stressor, and cases of inadequate stress relief contribute to the development of alcohol dependence. Family and individual psychotherapy and drug addiction treatment are essential for patient.