A 40-year-old patient is registered in a narcological dispensary. Somatically: skin is dramatically hyperemic, sclera are injected, hyperhidrosis is present. BP- 140/100 mm Hg, heart rate - 100/min. Mental state: autopsychic orientation is intact, allopsychic orientation is distorted. The patient presents with motor anxiety. There is an expression of fear on his face. He refuses to talk about his problems and asks to release him immediately, because he "may be killed". This state developed in a day after one of his regular drinking bouts. What is your provisional diagnosis?

Answer options

1. Alcoholic paranoid
2. Organic delirium
3. Paranoia
4. Alcoholic hallucinosis
5. Delirium tremens

Explanation

The test task describes the picture of delirium tremens (alcoholic delirium). Delirium tremens is characterized by a change in consciousness with a disturbance of all psychic orientation and the preservation of autopsychic, the presence of vital fear, “motor anxiety”, vegetative and somatic disorders (“Skin is dramatically hyperemic, sclera are injected, hyperhidrosis is present. BP-140/100mm Hg, heartrate100/min”). An additional clue is an information that “this state developed in a day after one of his regular drinking bouts”. Therefore, the correct answer is delirium tremens. Psychiatry: [Textbook] V.L. Gavenko, V.M. Sinayko, G.A. Samardakova and others; reduction by V.L. Gavenko, – Kharkiv: Region-inform, 2006. – 218 – 219 P.