7th International Conference on Addictive Disorders and Alcoholism
UMF Carol Davila, Bucharest, Romania
Title: Alcoholism and Crepuscular State. Medical Legal Potential of Dysbehavioural Changes
Biography: Simona Trifu
Research subject choice reasoning: The present case brings into discussion the alcohol pathology, occurred over a paranoid type personality structure, in which jealousy dimension is major.
Objectives: The patient reaches the guard room of psychiatry hospital for death threats addressed to his own children, including ritualic scenes for anticipation scenes, all these being carried out on the changed background of consciousness (the development of a crepuscular state with the preservation of motor automatisms and relative post-critical amnesia).
Hypothesis: Patient’s speech suggests in après coupe a crepuscular state with the narrowing of consciousness field and preservation of motor automatisms, potentiated by the increased alcohol consumption at the respective moment. The same idea is supported by the partial post-critical amnesia and by patient’s inability to order chronologically the events of that period. At the same time, at the assessment moment, he dissimulates the seriousness of acts and has confabulatory explicative constructions.
Materials and methods: EEG, MRI, psychological assessment (psychometric examination - clinical scales: Hamilton anxiety scales and Hamilton depression scale), projective examination - Lusher color test and Szondi test - destiny analysis), clinical interview, observation, psychiatric treatment.
Results: The patient is slightly inner-tensioned, with attitude of embarrassment and willing to get out of this situation, confused by the acts committed and by their consequences, trying to have a “picture” attitude, offering expected answers and potentially valid counter-arguments for each sequence of behavioral acts. He offers tangential information related to the acts committed.
Conclusions: A difficult recalling is acknowledged, entangling the chronology of events committed, thing suggesting the possibility of a crepuscular state, potentiated by the alcohol consumption at the critical moment of the action, when he threatened his children with death.