Abnormal Diagnostic Manual

Alcohol dependence (Korsakov psychosis 03)

In the auditorium A, Qi Yu is giving a speech on the psychology of AIDS.

The times are developing and the society is progressing. With the emancipation of some brick-and-mortar experts, some safety education in universities has become essential. Many simple children are fortunate to see the appearance of condoms for the first time, and it also makes them less innocent. A lot of children have learned about the dangers of unsafe sex behaviors.

Everyone who has gone to middle school knows that AIDS (AIDS) is caused by the human immunodeficiency virus (HIV). During unprotected sex, sharing a hypodermic needle, transfusion of blood carrying the virus, or in the womb (in newborns of infected mothers).

Once the virus is activated, it attacks the immune system, leaving the body defenseless against various infections.And HIV may remain dormant for a long time.

As a cutting-edge psychological expert, Qi Yu certainly did not come to simply popularize AIDS prevention. In fact, his topic was the biological mechanism of the psychological effect on the disease.

The development of AIDS is not the same for all, and the time from HIV infection to diagnosis of AIDS and the time from diagnosis of AIDS to death vary greatly among individuals.Many factors determine this rate of difference, including genetics, age (the older age is shorter) and the specific type of HIV virus. Qi Yu explained the impact of behavior, personality, stress and social support on the development of HIV.

CD4 cells (T cells) are the main predictors of HIV development. With the reduction of CD4 cells, HIV infection gradually deepens. When CD4 cells decrease to a level of 200 per milliliter of blood, the individual will be diagnosed with AIDS. AIDS patients are almost Loss of all natural immune function.

Psychologists found in the study that after being diagnosed as HIV-positive, patients with a more optimistic life center and a more positive mood had a higher number of CD4 cells.Among gay men living with HIV, those who were in the closet had lower CD4 cell counts.For people with lower income and poor interpersonal relationship, the correlation between CD4 cells and HIV is higher. Therefore, when infected with HIV, taking a more active way to deal with it will help strengthen the immune system.

Zhou Nan calmed down and listened to Qi Yu's report, and it took a lot of effort to drag Qi Yu away from the crowd who wanted to sign and ask questions to express their love, and discussed with Qi Yu the description of He Zhiqiang's disturbance in the police station .

According to the data and descriptions of personal and social relationships investigated by Zhou Nan, He Zhiqiang should have suffered from Korsakov's psychosis, which is a serious memory impairment and is believed to be caused by vitamin B deficiency.

Diagnosis of typical Korsakov psychosis is not difficult.

Clear consciousness but significant memory impairment, while other cognitive functions remain largely intact, can be diagnosed as Korsakov psychosis.The Wechsler Adult Intelligence Test (WAIS) results of Korsakov psychopaths are often within the normal range, but the Wechsler memory test scores are at least 20 to 30 points lower than normal people.

Amnesia is one of the most prominent and serious symptoms of Korsakov's psychosis. It does not refer to the general decline of memory, but refers to a loss of memory, which includes anterograde amnesia and retrograde amnesia.Anterograde amnesia refers to the inability to recall events experienced some time after the onset of the disease, while retrograde amnesia refers to the inability to recall events at a certain stage before the onset of the disease.

Some Korsakov psychopaths also have misconceptions, saying that events that they experienced in their past life but did not happen during the period he described happened at that time, and they firmly believe it and give it to them. corresponding emotional responses.Due to memory loss, the patient cannot correctly describe the process of events, or can't figure out the sequence of events before and after the events, but in order to fill in the gaps in this aspect, the patient says that the events that happened in the past time are this time. occurring.

He Zhiqiang has obvious performances in this regard - he has the memory of living with his son, but he has blurred the time of his son's accident.His son He Ming is in the third year of college and committed suicide three months ago, while He Zhiqiang's memory is that his son ran away from home when he was in middle school.

The diagnosis of alcoholic Korsakov psychosis is based on memory impairment, impaired time perception, history of chronic alcohol or drug use, apathy, lack of priming, and personality changes prone to self-neglect.

A less common but frightening complication of chronic alcohol dependence is delirium tremens (DTs).This severe reaction is actually a withdrawal symptom that occurs when blood alcohol levels drop suddenly.For example, patients usually drink three bottles of wine a day, and suddenly there is no wine to drink one day, they will tremble violently, sweat profusely, appear disorientated, and have nightmarish hallucinations.This dire condition usually lasts 3-6 days, after which the patient will take a vow never to drink again, but the vow is often broken within a few days.

The first step in the treatment of alcohol dependence is detoxification, that is, clearing the body of alcohol, and then helping the patient get through the withdrawal symptoms.Doctors usually prescribe tranquilizers for about a week to prevent convulsions (convulsions can occur in chronic alcoholics who suddenly stop drinking).At the same time, in order to prevent malnutrition and dehydration, patients should take a large amount of vitamins and liquid substances as prescribed every day.

Through this process, the toxic effects of alcohol are removed from the body, and the body returns to a near-normal state.Behavioral change, however, is the main goal of rehabilitation—the effort to turn a disorganized patient with a disrupted social, family, and professional life into a wholesome, self-sustaining, socially readjusted normal human being.

This touches on many aspects of the life of an alcohol dependent person, so better recovery approaches take many forms.

Examples include occupational therapy – helping patients learn or relearn job skills;

relaxation training - teaching patients how to reduce tension without alcohol;

Group and individual therapy - helping patients understand themselves and showing them how to relate to others without drinking;

Family and Marriage Therapy - Addressing issues in the family that may have prompted them to drink or caused them to drink.

There are also Alcoholics Anonymous (AA) and other self-help groups.

Qi Yu was still explaining to Zhou Nan the treatment methods for alcohol dependence and He Zhiqiang’s individual treatment methods, when he heard a noise in front of him, saying that someone drowned in the South Lake—the lake where He Ming committed suicide (due to the spread of the suicide incident) , which has rapidly transformed from a dating mecca to a haunted place).

Zhou Nan and Qi Yu looked at each other, and they followed the curious crowd towards Nanhu.

When Zhou Nan and Qi Yu arrived, the police had sealed off the surrounding area, and the body had been salvaged. Zhou Nan took a few steps closer, and the deceased was He Zhiqiang!