Intoxication

Clinical symptoms of alcohol intoxication depend on the blood alcohol concentration ( BAC) as well as on the individual's level of tolerance. Whereas in healthy persons without alcohol tolerance it is possible to distinguish mild intoxication (BAC £ 100 mg per cent), medium intoxication (BAC 100-200 mg per cent), and severe intoxication (BAC > 200 mg per cent), this schema is too simple for alcoholics. In these people, different levels of tolerance can lead to completely different clinical pictures despite their having similar blood alcohol concentrations. Thus, psychopathology is more important than blood alcohol concentrations for estimating the severity of an acute intoxication state. With increasing BAC we observe elated mood, disinhibition, impaired judgement, belligerence, impaired social and occupational functioning, mood lability, cognitive impairment, reduced attention span, slurred speech, incoordination, unsteady gait, nystagmus, and stupor or coma.

The term 'pathological intoxication' can still be found in the older literature (reviewed by Lishman (1,)). It was described as an outburst of aggression and uncontrollable rage, which might have led to serious destructions. As a rule, this behaviour, which was not typical for the individual, ended in terminal sleep and subsequent amnesia. However, since there is not enough empirical evidence for the existence of this syndrome, it was no longer considered in DSM-IV. (2)

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