Psychiatric Implications of Nutritional Deficiencies in Alcoholism

Review

Psychiatry Investigation 2005;2(2):44-59.

Byung Joo Ham, MD, PhD; and Ihn-Geun Choi, MD, PhD

Department of Neuropsychiatry, Han-Gang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Abstract

<p class="MsoPlainText" style="word-spacing: 1; line-height: 150%; margin-top: 0; margin-bottom: 0" align="left"><font face="HY중고딕" size="2">Malnutrition is common in chronic alcoholics. Hypocalcemia, hyponatremia, hypokalemia and, hypophosphatemia have all been associated with chronic alcoholism. Alcohol intake is also associated with low serum magnesium, selenium and zinc levels. Water-soluble vitamins, such as vitamin B₁
, B₂
, B₃
, B₆
, B₉
and C, and fat-soluble vitamins, such as vitamin A, D, E and K have also been reported to be deficient in alcoholics. General causes of malnutrition in alcoholics are inadequate nutrient, particularly lack of water-soluble vitamins in their diet, reduced uptake, impaired utilization, increased requirements of nutrients and genetic predisposition to nutrient deficiency. Nutrient deficiencies are, therefore, a virtually inevitable consequence of alcohol abuse, not only because alcohol displaces food, but also because alcohol directly interferes with the body's use of nutrients, making them ineffective even if they are present. Chronic alcoholics exhibit a number of neurological disorders which are related to nutritional deficiencies, in particular vitamin deficiencies that are essential for normal cerebral functioning. Specific vitamin and nutrient deficiencies arising in chronic alcoholics may result in severe functional impairment and tissue damage, mainly neuronal and vascular, in the brain. Nutritional deficiency in alcoholics also causes neurotransmitter dysfunction, ion channel dysfunction, oxidative stress and metabolic dysfunction in the brain. Nutritional deficiency in chronic alcoholics frequently leads to a mild to moderate cognitive impairment, including impairment in perceptual-motor skills, visual-spatial functions, learning/memory, and abstraction and problem solving. There are a number of nutritional deficiencies which need to be cared for but magnesium, thiamine, and other B vitamins need to be administered immediately. Nutritional therapy can aid in the recovery from alcoholism. Patients who have received nutritional therapy reported significantly less alcohol craving as well as significantly greater nutrient intakes, and a greater number abstained from alcohol. Although abstinence and proper nutrition remain the cornerstones of treatment, pharmacological modification of neurotransmitter function and/or enhancement of cerebral metabolism combined with behavioral methods may also be beneficial.

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Key words Alcoholism;Nutrition;Deficiency;Neuropathology;Neurophysiology;Neuropsychology.