Wernicke-Korsakoff syndrome

Alcohol abuse is one of the most serious problems in public health and the Wernicke-Korsakoff syndrome is one of the gravest consequences of alcoholism.

The term Wernicke-Korsakoff relates to two conditions: Wernicke’s encephalopathy and Korsakoff’s syndrome. As these two conditions are so closely related the diagnosis is frequently referred to as Wernicke-Korsakoff syndrome.

Wernicke's disease is associated with nutritional deficiency, especially due to alcoholism. Alcohol can damage the lining of the stomach, which affects the absorption of vitamins, leading to thiamine deficiency. Korsakoff's psychosis is a mental disorder in which retentive memory is hugely impaired in an otherwise responsive patient. This disorder is also associated with alcoholism and malnutrition.

The cause of Wernicke-Korsakoff syndrome is a deficiency of thiamine or vitamin B1. Thiamine helps brain cells produce energy from sugar. When levels fall too low, brain cells cannot generate enough energy to function properly. Individuals with poor nutrition for any reason are at risk for this disorder. The most common social factor associated with Wernicke-Korsakoff syndrome is chronic alcohol abuse, leading to decreased absorption and utilization of thiamine.

It is important to note that there are nonalcoholic causes of thiamine deficiency, which can also produce Wernicke-Korsakoff syndrome. These include individuals with malnutrition, starvation, schizophrenia, anorexia nervosa, prisoners of war, and terminal malignancies.

Wernicke – Korsakoff syndrome: main clinical features
* ophthalmoplegia
* nystagmus
* ataxia
* confusional state
* amnestic disorder
* peripheral neuropathy

Mortality usually occurs secondary to infections and hepatic failure, but some deaths are attributable to defects of prolonged thiamine deficiency. The mortality rate is 10% to 15% in severe cases.

The most effective prevention of Wernicke-Korsakoff syndrome is to avoid the excessive intake of alcohol.
Wernicke-Korsakoff syndrome

Mental disorder populations

Mental disorder populations
Active planning was implemented to treat people with mental disorder in their communities in order to decrease all health care costs. There are thee major populations of individual who may be community based or outpatient mental health care consumers:

The physically disabled or elderly infirm who require home services for mental; health care. These individuals use a variety of payment options that affect the quality and duration of their care at home. The first two payment options, Medicare and Medicaid, which are sponsored by the federal and state governments, are the most common options for individuals in this category. In addition to Medicare and Medicaid, health care costs are funded by private health insurance, health maintenance organizations, or self pay.
Individual with nondisabling mental disorders who are able to continue working and fulfilling their normal social roles. The ability of such individuals to continue their normal roles is supported by the use of psychotropic medications. Psychotropic medications alter the neurochemistry of the brain so that brain chemistry approaches more normal levels. Disabling mental symptoms are reduced to more comfortable levels. Outpatient individual or group therapy augments pharmacotherapy.

Individual who are psychiatrically disabled. There is a growing percentage of people with chronic, disabling mental disorders because of the decreasing public and private support for mental health services. This segment of the population is particularly affected by the current crisis in health care costs. Inadequate funding and lack of comprehensive policy planning left woeful gaps in care, particularly when accompanied by the national trend of deinstitutionalization. Currently, the most commonly used treatment option open to the chronically mentally client is the community mental health center.
Mental disorder populations