Prediction of cerebral dysfunction in alcoholics; a study of health insurance records.

Abstract

Health insurance records of 45 men and 3 women alcoholics (including 6 having Korsakoff''s psychosis) voluntarily admitted to the University Hospital of Lund, Sweden, during the yr 1968-1972 were examined for information on the number of days and periods of physical and mental illness during the 5 yr preceding their hospital examination (or, in the 6 Korsakoff patients, during the 5 yr preceding the onset of the psychosis). The subjects had drunk excessively for 5-40 yr (average 18 yr). Subjects were given 10 psychometric tests and 1 wk after admission, their cerebral blood flow was measured. Many days and periods of mental illness were associated with lower job stability, a higher divorce rate and a higher number of previous admissions to psychiatric wards and institutions for alcoholics; many days and periods of physical illness were associated and lower job stability but not with the other variables measured. Many periods of mental illness were associated with more blackouts and with total neglect of food during drinking bouts, while few periods of mental illness were associated with more signs of low vitality and with poorer psychometric performance. Compared with the other alcoholics, the 6 Korsakoff patients (3 women) had fewer periods (mean 0.5 vs. 5.7 P < 0.01) and fewer days (18 vs. 208 days) of mental illness but more days of physical illness (234 vs. 145), and their immediate reproduction and retention on the Cronholm-Molander Paired Associates Test were significantly lower (P < 0.001). Findings in the Korsakoff patients were similar to findings in other alcoholics having few periods of mental illness. These alcoholics were socially more stable but had more signs of cerebral dysfunction than did alcoholics having more periods of mental illness. Alcoholics having few periods of mental illness have better control of their drinking and manage to drink more consistently during long periods than do other alcoholics, thus exposing their brains to more alcohol and to resulting brain dysfunction.