Seasonality and Delirium Tremens in Hospitalized Patients with Alcohol Dependence Syndrome

Abstract

<b><i>Introduction:</i></b> Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS). <b><i>Methods:</i></b> A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ<sup>2</sup> tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality. <b><i>Results:</i></b> The highest incidence of DT was in spring (36.8%; χ<sup>2</sup> (3) = 27.666; <i>p</i> < 0.001), especially in March (13.9%; χ<sup>2</sup> (11) = 33.168; <i>p</i> < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables. <b><i>Conclusions:</i></b> The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.

Characterization of alcohol‐related seizures in withdrawal syndrome

“…24,[30][31][32][33][34][35] By demonstrating that the presence of DT has an explanatory role in developing ARS, our results support these observations. Moreover, although several reports have evaluated that various factors such as older age, male sex, high blood level of homocysteine, low platelet count, low potassium level, and psychiatric and somatic co-morbidities can be risk factors for developing DT, 19,36,[43][44][45] the interplay of the occurrence of ARS and DT has not been evaluated in detail. Some studies have suggested that the ARS in medical history can increase the risk of the development of DT via the kindling mechanism.…”

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

“…Alcohol dependence syndrome is a recurrent and chronic brain disease caused by central nervous system poisoning caused by habitual excessive drinking (23). On the one hand, alcohol dependence will damage the patient's physical and mental health, on the other hand, it will also bring great burden to the patient's family, and even cause family breakdown in severe cases, which will lead to a series of social problems (24).…”

Delirium Tremens: A Review of Clinical Studies

“…These studies helped identify high-risk patients who developed DT. The demographic profile of these populations typically consisted of middle-aged males with comorbidities and a history of long-term alcohol abuse [40][41][42][43][44][45][46]. Efforts should be directed toward prevention, early intervention, and long-term treatment of alcohol dependence to reduce the burden of DT and associated complications.…”