Background: Alcohol use disorders, defined as the maintenance of alcohol use for at least a 12-month period despite negative psychological, biological, behavioral and social consequences, are frequently associated with psychotic symptoms.
Objective: Our aim in this paper is to review alcohol-related clinical conditions that are accompanied by psychotic symptoms: alcohol-induced psychotic disorder, alcohol withdrawal delirium, Wernicke’s encephalopathy, Korsakoff’s dementia, comorbid schizophrenia or delusional disorder.
Methods: This is a non-systematic, narrative review based on the relevant literature indexed in PubMed and Google Scholar databases [2000-2020].
Results: Alcohol-induced psychotic disorder is characterized by the presence of auditory hallucinations or delusions. In states of alcohol withdrawal, tactile and visual hallucinations are common, as well as delusions of varied content. Wernicke-Korsakoff syndrome, caused by malnutrition secondary to chronic alcohol misuse, is characterized by the presence of ataxia, ophthalmoplegia and a range of mental disturbances. The dual diagnosis of schizophrenia and alcohol use disorder rests on shared biological impairments, as shown by neuroendocrinological and brain imaging studies. The subtype of a delusional disorder called Othello’s syndrome, or delusional jealousy based on false beliefs of infidelity, is often seen in the context of alcohol alone or alcohol and neurological disorder. Treatment for alcohol with psychotic symptoms is dietary, psychological, and pharmacological.
Conclusions: There are a number of alcohol-related psychotic syndromes, each requiring its own specific treatment approach.