ALCOHOLIC HALLUCINOSIS: This involves experiencing auditory hallucinations in clear consciousness - especially singing / music. The hallucinations occur when the drinker is intoxicated - not when in withdrawal. Alcoholic hallucinosis is thought to be caused by the effects of alcohol on the central nervous system.

ANXIETY: Heavy drinking is strongly associated with anxiety-related problems. The anxiolytic (anxiety-reducing) properties of alcohol are particularly attractive to those who are anxiety-prone. Prolonged heavy alcohol use often exacerbates anxiety problems - leading to panic attacks, agoraphobia, etc.

DEPRESSION: This is a very common cause / sequel of heavy drinking. There is often a "viscous circle" of deepening mood and escalating alcohol use. Alcohol problems are associated with 60% of parasuicides. The rate of suicide amongst heavy drinkers is 60 times that of the general population. Research reveals that approximately 20% of heavy drinkers have attempted suicide. The treatment of alcohol problems is often complicated by feelings of hopelessness, helplessness and other features of clinical depression.

KORSAKOFF'S SYNDROME: This syndrome is believed to be caused by thiamin deficiency and the toxic effects of alcohol. It is often preceded by Wernickes' encephalopathy. Damage to certain areas of the brain including the mamillary bodies, brainstem and cerebellum can result in the severe disruption of short-trem memory - though other cognitive functions remain relatively unimpaired.

MORBID JEALOUSY: This syndrome involves a delusional belief that his / her partner is unfaithful and there are often constant accusations of infidelity, searching for evidence, etc. Morbid jealousy is associated with a significant risk of violence. The syndrome can occur in the absence of an alcohol problem. The syndrome is also known as the Othello syndrome.

PARANOID STATES: These Include delusions of being watched, followed, plotted against, etc. These effects may be exacerbated by alcohol withdrawal and intoxication.

PERSONALITY: The concept of the "addictive personality" has been heavily criticised. Heavy / prolonged drinking, however, may cause frontal lobe damage that can lead to a "coarsening" of character, an inability to learn new material, difficulties in adapting to change, poor social judgement, etc.

SCHIZOPHRENIA: Approximately 1/3 of community mental health team clients diagnosed as schizophrenic have been found to have problems with alcohol or street drugs (Maudsley Dual Diagnosis Project). Drinking may be an often be an attempt to self medicate - eg. to reduce the intensity of hallucinations. Schizophrenics are thought to be more vulnerable to the effects of alcohol. In some cases treatment compliance may be poor.

SUICIDE: Research by the Department of Health (1993) suggests that around 65% of suicide attempts are linked with excessive alcohol use. Alcohol problems are a significant factor in male teenage suicides (Royal College of Physicians, 1995). Alcohol use is also strongly associated with deliberate (non-suicidal) self-harm (Acheson, 1998).