Alcohol-induced psychosis and delirium tremens: a comparison with alcohol dependence on demographic characteristics, mortality, and morbidity

TL;DR

This study compares health outcomes of patients with alcohol-induced psychosis, delirium tremens, and alcohol dependence, finding significant differences in mortality and comorbidities.

Contribution

The study provides new insights into the distinct health profiles and outcomes of patients with alcohol-induced psychosis and delirium tremens compared to alcohol dependence.

Findings

Delirium tremens patients had the highest mortality and comorbidity rates.

AIP patients were younger and had higher rates of schizophrenia spectrum disorders.

AIP patients did not show higher mortality than AD patients but showed a link to psychotic disorders.

Abstract

The study aim was to compare patients with alcohol-induced psychosis (AIP) and delirium tremens (DT) with patients with alcohol dependency (AD) only. Using data from Norwegian Patient Registry (NPR) we investigated demographic characteristics, mortality, and physical and mental health comorbidities, among individuals with AIP or DT compared with AD patients.

Data from NPR was used to create a cohort of patients aged 20–79 diagnosed with either AIP, DT or AD, from 2009 to 2015. If patients received more than one of these diagnoses, AIP and DT were prioritized. For patients with both AIP and DT, the earliest diagnosis took priority, except when the diagnoses were assigned simultaneously, when DT was prioritized. Data on comorbidities were taken from NPR, while cause of death was obtained from the Norwegian Cause of Death Registry. Estimates were compared using chi-square test and the Kruskal-Wallis test with Bonferroni adjustments for multiple testing. Mortality was analysed using Cox regression models and by calculating standardized mortality ratios, adjusting for age and gender.

The cohort included 33 107 patients diagnosed with AD, 1 784 with DT, and 700 with AIP. AIP patients were the youngest. DT patients displayed significantly higher mortality rates, with an annual rate of 8.0%, and generally increased comorbidity rates. AIP patients showed significantly higher rates of schizophrenia spectrum disorders compared to both AD and DT patients, highlighting a potential link between AIP and psychotic disorders.

This study reveals that patients with DT experience higher morbidity and mortality rates compared to those with AIP and AD. AIP patients did not show increased all-cause or cause-specific mortality compared to AD patients across a variety of causes. Notably, AIP seemed to be more closely linked to comorbid schizophrenia spectrum disorders than AD and DT patients. The findings underscore the complexities of AIP in relation to schizophrenia and highlight significant differences in health outcomes among the three patient groups.

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