Alcohol abuse affects all systems of the body. The brain suffers as much as the kidneys, liver, or heart. According to statistics, a quarter of people with alcoholism show signs of schizophrenia. At the same time, the latter may be a consequence and cause of binge drinking. Scientists have long studied the relationship between these two phenomena. This article will explain how Alcoholic Schizophrenia occurs, manifests, and is treated.


alcoholic schizophrenia


Stating the Problem

There are two points of view on the connection of alcohol addiction with schizophrenia. According to the first one, the psychiatric disease is formed on the background of alcoholism. The latter causes severe brain lesions, accompanied by hallucinations, delirium, speech disorders and impaired motor activity. If a person has a hereditary predisposition to schizophrenia, alcohol abuse can be the trigger for its emergence.

According to the second point of view, alcoholism is often a consequence of the development of mental illness. The fact is that a person in a state of psychosis, delirium, stress or depression often chooses alcohol to relax and unwind. And sometimes alcohol does help to eliminate hallucinations and delirium, as it triggers the “braking” system of the brain. However, subsequently, the condition can worsen. Doctors are faced with two problems at once: withdrawal from drinking and treatment of schizophrenia.

In all cases, alcoholic schizophrenia is complex, and its course is unfavourable. First, it is connected with the fact that remission in alcoholism is extremely unstable. Psychosis may flare up at any moment, should the person go on a binge. Even the slightest factor may provoke another “binge”. As a result, the person and his environment are almost constantly in the risk zone.


Alcoholic Schizophrenia Causes

Ethyl alcohol and its breakdown products have a powerful effect on nerve cells. Schizophrenia, in principle, is a consequence of the disruption of neurotransmitters, which provide communication between neurons of the brain. In this case, any damage to it can lead to various diseases, including psychiatric.

Alcohol weakens the cells and the signals between them, so they can not fully function. In simple terms, there is severe inhibition in the brain’s hemispheres. It can be a triggering factor for the development of schizophrenia or an exacerbation if you already have the diagnosis.

Frequent consumption of alcohol also causes depression, lack of initiative and apathy. During periods of remission, the person may be irritable or even angry. Similar symptoms are characteristic of schizophrenic disorders of various types. Therefore, if the alcoholic has a predisposition to schizophrenia, the risk of its occurrence increases with the development of alcohol dependence.

Alcoholism, too, is almost 50% genetically determined. If you have a family history of mental illness and a predisposition to alcohol, you should exclude it from your life. Otherwise, your risk of developing alcoholic schizophrenia doubles.


Alcoholic Schizophrenia Classifications

Alcoholic schizophrenia is classified into types on several grounds. One of them is the nature of the course of the disease. According to this indicator, the following types of pathology are distinguished:

  • Unfavourable – proceeds rapidly with pronounced symptoms. The patient quickly degenerates, and the disintegration of the personality is inevitable.
  • Continuous – schizophrenia develops in a chronic form, characterized by changing periods of exacerbation and remission.
  • Seizure-like – the disorder manifests itself only once in a lifetime.
  • Seizure-progressive – the disease runs with alternation of attacks and remissions, but with each exacerbation, the symptoms become more and more, eventually leading to the disintegration of the personality.

The course of alcoholic schizophrenia is mainly influenced by the frequency of alcohol consumption and the quantity and quality of alcohol consumed.

In true alcoholic schizophrenia, the first attack occurs against a background of severe intoxication.

According to the severity of symptoms, this pathology is divided into two types:

  • Paranoid, which is accompanied by vivid hallucinations and delirium.
  • Sluggish, in which the patient behaves inadequately only during binge drinking.
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Another classification is based on the dominant symptom. According to it, alcoholic schizophrenia is divided into such varieties as:

  • White fever – a state of alcoholic delirium after a long binge. It is manifested in speech disorders, spatial disorientation and hallucinations of an aggressive nature. The patient is terrified for his life. He can be afraid of both people and otherworldly forces (“devils”). The person cannot fall asleep at night, and if he falls asleep, he has nightmares, walks lethargically, and is tired during the day. Delirium ends with prolonged sleep.
  • Hallucinosis – is accompanied by hallucinations, loss of communication with reality and delirium, which is usually associated with persecutions and conspiracies. Often the person in this condition hears voices that swear, scold him, and generally have an aggressive attitude. Often this leads to the patient attacking those around him.
  • Delusional psychosis – characterized by increased motor activity, anxiety and aggression. The patient is constantly agitated, therefore, often gets into fights.

As you can see, such symptoms are not very different from the signs of some forms of schizophrenia. The alcoholic form is not distinguished as a separate variety under the ICD-10. Sometimes it is referred to as a condition rather than a disease.

Having two or more types of disorders in a patient is called comorbidity.

If the person already has a mental disorder and abuses alcohol, they will have more seizures. However, the medical record will not show alcoholic schizophrenia but a different diagnosis, such as paranoid, seizure disorder, sluggish or catatonic schizophrenia.


Alcoholic Schizophrenia Symptoms

The first signs of alcoholic schizophrenia appear 5-7 years after the first binge. The symptomatology, which is partially described earlier, is determined by the type of the disease, and its precursors are most often the following symptoms:

  • Apathy, depressive state;
  • Sleep disturbances, nightmares;
  • Unreasonable anxiety;
  • Increased irritability;
  • Memory lapses;
  • Suicidal moods;
  • Cognitive decline.

Later on, there will be more and more signs. Gradually, symptoms such as:

  • Persecution mania;
  • Tremors and seizures;
  • Repetition of movements and words;
  • Sudden mood swings;
  • Suicidal attempts;
  • Hallucinations;
  • Catatonic disorders;
  • Large memory lapses.

If a patient has schizophrenia and alcoholism, his life expectancy is shortened by 10-15 years on average.



Clinicians have identified the following patterns associated with alcohol-associated schizophrenia:

  • 25% of patients have one episode of the disease, and another 25% have a chronic disease course.
  • The remaining 50% have the possibility of joining both the first and second groups. It all depends upon their decision to stop drinking alcohol.
  • If alcohol schizophrenia occurs very young, the consequences will be more devastating.
  • It is much easier to treat an acute illness, as it has clear signs, than a chronic type disease, which is more insidious because of the latency of the symptoms.
  • Alcoholic schizophrenia has the same course in men and women, but the former suffer from it more often because, in principle, they consume more alcohol.

In general, almost 80% of patients develop some mental disorders against the background of addiction.


Alcoholic Schizophrenia Treatment

Treatment of schizophrenia with addictions, that is, all kinds of addictions, is complicated and lengthy. Additional specialists need to be involved. Because of constant breakdowns, remissions will be shorter, and the attacks will be more intense. At the same time, practice shows that it is ineffective to treat each pathology separately. The patient needs to be admitted to a clinic where a psychiatrist and an anesthesiologist will observe him.

First, taking the patient out of the drunken state is required. In general, alcoholics have prescribed the following types of therapeutic measures:

  • Detoxification – elimination of products of ethanol decay from the body. Patients are usually given IV fluids.
  • Immunostrengthening therapy – the use of immunoprotection and vitamins. Physiotherapy procedures, proper nutrition, walks in the fresh air, etc., are also prescribed.
  • Rehabilitation is further medication, psychotherapy and psychological support to prolong remission.

Schizophrenia symptoms are relieved with neuroleptics, tranquillizers and other drugs, depending on the patient’s condition. However, all these measures will be effective only if the patient ultimately gives up alcohol.

As for coding, it brings no results because it is based on self-infusion. For people with schizophrenia, such barriers, that is, psychological prohibitions, are easily overcome during moments of life crises.



A lethal outcome is possible with severe brain damage if the patient does not refuse to drink alcohol. There is also a high likelihood of a person being declared legally incompetent because of his behaviour’s unpredictable and aggressive nature.

Each subsequent binge will lead to more severe conditions and a more significant number of symptoms. This lifestyle also develops many other illnesses that alcoholics usually suffer. We are talking about cardiovascular abnormalities, liver disease, etc.

Suicide is the outcome of 5-10% of schizophrenia cases. The risk increases many times over in the presence of addictions.

Quitting alcohol altogether can help prevent this. However, with schizophrenia, a very unpredictable disorder, even preventive measures do not always help rule out the possibility of another attack.

Depending on the stage of remission, can give several prognoses:

  • No pronounced personality changes, the person does not lose professional skills, and there is an opportunity to restore all mental functions.
  • There is residual symptomatology. Though the weak, the ability to work is restored; regress is possible.
  • There is no criticism of his condition. There are residual symptoms, and professional skills are lost, but the ability to do simple tasks at home under supervision is maintained.
  • Aggression is not expressed, symptoms are weak, and the patient remains in an inpatient facility where he can work a little if he wants.
  • No therapeutic effect, symptoms remain pronounced, the further treatment is necessary.

Alcoholism in schizophrenia does not go away entirely without a trace. The patient will remain cognitive impairment, and becoming healthy again, i.e. cured forever, is not possible, although there are cases when an attack is observed once in a lifetime. Much depends on the way of life of the person and the individual characteristics of the organism.