According to a joint report published by the World Health Organization and the European Commission in 2012, Europe is the region in the world where the most alcohol is consumed…
…and our country, one of the places where consumption begins at a very early age. In addition, we must bear in mind that this substance is in 90% of cases the “entry door” for simultaneous use of other drugs.
There are numerous negative repercussions that this has on a physical and organic level, since cardiovascular, gastrointestinal, pancreatic, hepatic, neurological, metabolic, motor, hematopoietic and even oncological pathologies could develop. But let's look at a lesser-known part: What is the relationship between excessive alcohol consumption and other pathologies, in this case, psychiatric or psychological?What intervention strategies have been developed?
Psychological consequences of alcohol addiction
There are several fundamental disorders induced by alcohol consumption:
- Transient psychotic episodes: They can occur in up to 25% of patients and are associated with an increased risk of delirium tremens. Sudden and fleeting alterations in perception occur, which can occur both during episodes of withdrawal and active consumption.
- Alcoholic hallucinosis: auditory and/or visual hallucinations accompanied by false recognition, delusional ideas, and altered emotional state. Auditory hallucinations can range from unclear sounds to well-defined messages. These voices may speak to each other or directly to the patient.
- Wernicke-Korsakoff syndrome: It is caused by a lack of thiamine (vitamin B1) and malnutrition associated with excessive alcohol consumption. It is characterized by memory loss, ataxia, tremors, confabulation, temporal-spatial disorientation and decreased level of consciousness.
- Delirium tremens: It is a severe form of withdrawal that involves sudden and severe neurological or mental changes: tremors, agitation, seizures, disorientation, delusions, hallucinations, tachycardia, excessive sweating, etc.
In addition to this, the excessive alcohol consumption It will have negative consequences on those patients already diagnosed with a mental disorder, so that if we add alcohol to:
- Anxiety disorder: Extreme caution will be necessary when using some anxiolytic medications (such as benzodiazepine) due to a higher risk of tolerance.
- Schizophrenia: will increase the risk of violent behavior, either due to the alcohol intoxication itself, the brain damage that such intoxication produces, or the reduced adherence to antipsychotic treatment resulting from it.
- Bipolar disorder: 50% of TB patients will develop problems related to alcohol use.
- Delusional disorders: Between 1 and 4% of patients with alcohol dependence admitted to Psychiatric Units will present jealousy, a delusional disorder most associated with excessive consumption.
- Personality disorders: People who suffer from borderline personality disorder have a risk 2.52 times higher than the general population of having problems related to excessive alcohol intake.
- Depressive disorders and suicide: The presence of excessive alcohol consumption can trigger a depressive episode, or precipitate a current one, aggravating, among other aspects, the risk of suicide.
Psychological interventions for excessive alcohol consumption
Despite the large number of interventions and treatments developed, everyone agrees that the most beneficial is a multidisciplinary approach of the alcohol addiction in which the biological, psychological and social dimensions of the problem are addressed. Well, from the point of view of psychologyinterventions that have been shown to be effective are:
- Brief interventions: There may be one or several sessions within a limited time. Normally, sessions with the psychologist last between 5 and 30 minutes and are mainly focused on counselling and educational guidance. They can be carried out by professionals who are not specialists in substance abuse: doctors, nurses, etc. They are usually effective in reducing alcohol consumption in people with risky intake and facilitate the implementation of a specific treatment in patients with problematic consumption.
- Interview and motivational therapy: It seeks to help the patient by increasing their motivation for change through the exploration, recognition and confrontation of their problems. Empathy is always used and emphasis is placed on the patient's own responsibility in solving their situation. This technique has proven effective in patients who are alcohol abusers and dependent on alcohol.
- Group therapies: It is one of the most enriching forms of psychological therapy, combining several different group techniques. It has been observed that the social component of belonging to a group, among other factors, improves the results compared to individual therapy.
- Cognitive-behavioral therapies: They are a structured, directive, time-limited form of therapy that combines behavioral approaches with cognitive strategies. They are effective for the treatment of alcohol-dependent patients compared to other psychological interventions and increase abstinence rates.
- Social behavioural therapies and networking: uses the social environment as a way to participate in achieving abstinence or controlled consumption. It includes strategies that help subjects build social support networks that facilitate change. It is an appropriate therapy that achieves results similar to others.
- Family-focused psychological therapies: There are times when the family is the setting in which problems related to alcohol consumption arise, so group work with the family is necessary. These therapies are effective, especially in motivating subjects to enter treatment. They have proven to be a superior intervention to individual counselling, group psychotherapy or psychoeducation groups. They manage to increase adherence to treatment, reduce alcohol consumption, improve family functioning and facilitate the patient's incorporation into their social life.
- Mindfulness: This is defined by paying attention to the present moment without prejudice and becoming aware of your reactions, feelings or thoughts. It is not about controlling the desire to drink. It is about keeping you in observation, allowing natural self-regulation mechanisms to exert indirect control over the reduction of symptoms. The usefulness of Mindfulness as a complement to relapse prevention programs has been demonstrated.
In order to establish which is the best treatment for each subject, a thorough investigation must be carried out beforehand. assessment In this case, through the relevant tests and the life history of each individual, the professional will conclude which is the most effective and beneficial way of working in each specific case.
Therapies that may be useful to you