Alcohol Dependence

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Introduction:
As a part of my clinical experience in psychiatry, I was posted in valankini ward. I came across a client by name Mr. Shankappa is admitted with complaints of alcoholism, grandeous ideas and aggressive behavior. As I was interested in him I took his for my case study.

Baseline data:
Name of the Head of the Family| Mr Shankappa. H. P|
Age| 23 years|
Sex| Male|
Educational status `| 9 th standard|
Marital status| Unmarried|
Address| Sediyapu house, kodiyadi village post, puttur|
Religion| Hindu|
Ward| Vailankani|
Date of admission| 10/09/09|
Diagnosis| Alcoholic dependence with intoxication|
Informant| Wife|
Infomant reliability| 80%|

Presenting cheif complaints:
Psychotic complaints: Associative complaints Frequent lying- 1 month Physical injuries-
Stealing- 1 month- near left eye
Involvement in anti-social activities – 1 month -bridge of the nose Increased talk- 1month High self esteem- 1month Grandiosal ideas- 15 days

Assaultive & irritable behaviour- 1 week
Pre-disposing factors: Sudden onset & progressing gradually Precipitating factors: Pleasure seeking & craving
Aggravating factors: -Love failure
-Frequent accidents

INFORMANTS’ VERBATIM:
Accorsing to the patient:
Mr Shankappa has studied up to 9th standard ( incomlete) after which he had lost interest in studies & joined in his father’s business because of which his girlfreind left him. After this incidence patient started to consume alcohol, felt betrayed & could not stay in his hometown. So he ran away to Mumbai & worked their for an year, Came back & joined in a travel agency for 6 months. He was working as an autodriver during which he met with an accident, According to the informant:

He was spotted by his brother in law when he is intoxicated on 28/10/09. He was also noticed to have a physical injuries ( Patient reports that he met with an car accident). Last drink – 90 ml 12 pm 28/10/2009, was hospitalised & was rested for 2 months & left to Delhi for a Job, where he started consuming alcohol again & was brought back to Mangalore. HISTORY OF PRESENT ILLNESS:

Patient was apparently normal around 12 year back when he discontinued in 9th standard & his love failed. He started to work in his father’s hotel . He would go to supply tea to nearby bar, where he started consuming alcohol. Parents were not aware of that till 3 years.

Patient started to work in Vikram travels at the age of 17 years . He use to come back home intoxicated with 2 – 3 bottles . He was not supporting their parents financially.
He was beggging money of Rs 1000-2000 with the familiar persons & wouldn’t returns it. Patient is not going to work since 3 months , keeps telling that he is working in canteen. He often steals money from the hotel. One week back he left from home saying that he will go for a job , but he didn’t come back. According to the patient , he has studied up to 9th standard ( incomlete) after which he had lost interest in studies & joined in his father’s business because of which his girlfreind left him. After this incidence patient started to consume alcohol, felt betrayed & could not stay in his hometown. So he ran away to Mumbai & worked there for a year, Came back & joined in a travel agency for 6 months.

PAST HISTORY OF PSYCHIATRIC ILLNESS:
On 29/10/10 patient was admitted with history of road traffic accident and patient was admitted on 17/10/2008 in a hospital with the complaints of alcoholism, increased talk, elevated self esteem, grandiosely ideas, assertive behaviour and irritability and diagnosed to have BPAD and alcoholic dependent syndrome with head injuries. He was on antipsychotics and disulphuram therapy...
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