Inability to fully reproduce in memory the events that occur during alcohol intoxication

# 2

*! The big drug addiction consists, except

(consists of syndromes: altered reactivity, mental dependence, physical dependence)

# 3

*! A patient, 55 years old, a handyman. Delivered to the department of addiction therapy by the ambulance team. From the medical history of the disease it is known that has been abusing alcohol since 30 years. In the last 6 years, drinking bouts lasting from 3 to 10 days, daily tolerance increased to 1.0 liters of vodka. Intoxication is interrupted for external reasons. It cannot go out of binge on its own, in private it receives detoxification therapy. For several months he was in a religious rehabilitation program for admission. After returning home, he began to accuse his wife of having contacted the guys from the rehabilitation center, that she was cheating on him with them, that they wanted to take his apartment and house. In a mental status, he is cautious, secretive, at first he is reluctant to reveal his feelings at the conversation, “You will consider me crazy, I won’t tell you my problems,” later I began to talk very actively about the behavior of my wife and children from the rehabilitation center. He explains his hospitalization with the fact that "the wife wants to make him crazy, so that he does not interfere with her." Notes that he was always jealous. There is no criticism of his condition. What condition is MOST likely in this patient?

Stage II alcoholism

Alcoholic psychosis (alcoholic paranoid - delirium of jealousy)

#4

*! Patient K., 46 years old. From the anamnesis of life and disease it is known that from childhood I grew up quiet and calm in nature. After the 8th grade, he entered the construction college, where he began to drink 200-250 ml of wine after receiving a scholarship under the influence of a fellow student. Sometimes after this, vomiting was noted. Despite the fact that he did not like the state of intoxication, he could not refuse to drink, because he was afraid of condemnation from peers. After graduating from college he was drafted into the army, where he drank whenever possible. After demobilization, he worked at a construction site and drank 200-300 ml of vodka or 400-500 ml of wine up to 3-4 times a month. Vomiting after drinking ceased to occur.
At the age of 25, he married and after that for several months refrained from drinking. Then he began to drink again as before. Sometimes the next day I could not remember certain moments of the previous evening. He tried to refrain from drinking, made promises to his wife, but after drinking one glass, he could not stop then. Subsequently, he began to drink more, 500-600 ml each. vodka or up to 1 liter of wine. In a state of alcoholic intoxication, he became rude, irritable, and conflicting, as a result of which relations in the family and at work deteriorated. After family conflicts, there were attempts to refrain from drinking, which lasted only 1-1.5 months. At such moments, he felt "as if not at ease." Towards evening he “walked about” and for a long time could not fall asleep and woke up early. For medical help at the insistence of his wife. What is the most likely diagnosis for this patient?

Signs of stage I (initial) alcoholism:

Loss of a protective gag reflex

Build-up tolerance

Partial loss of quantitative control

Palimpsests

Changes in the form of intoxication