Condition and Changes
What is Korsakoff’s psychosis?
Korsakoff’s psychosis (KP) can occur following inadequately treated Wernicke’s encephalopathy (WE).1 It is chiefly a memory disorder, in particular loss of episodic memory.1,2 KP is another condition that falls under the Alcohol Related Brain Damage (ARBD) umbrella, often regarded as a more severe disorder with less positive outcomes.
The stigma and emotional burden suffered by patients and their families is significant8 and special residential costs for each patient with Alcohol Related Brain Damage (ARBD) is over £40,000 per year.9
What are the symptoms of Korsakoff’s psychosis and how common is it?
Working (recent) memory is generally impaired and people with KP are typically unable to remember incidents or episodes from their past, they may also have difficulty in learning new facts, concepts and language. Confabulation may also occur in KP.1 This may be the unprovoked outpouring of erroneous memories, i.e. events that have not happened, or memory distortions.
Without adequate treatment, up to 84% of patients with WE are found to develop Korsakoff’s psychosis when followed up long-term.3
How is Korsakoff's psychosis different from Wernicke’s encephalopathy?
WE is an acute neurological disorder caused by thiamine deficiency.1 Whereas KP can be defined as: “an abnormal mental state in which memory and learning are affected out of all proportion to other cognitive functions in an otherwise alert and responsive patient.”1
KP may be caused in part by thiamine deficiency, but also deficiencies of other nutrients and alcohol-induced neurotoxicity.4 The condition typically follows or accompanies WE, however symptoms of KP may not become apparent until the confusional state associated with WE resolves.5
WE can be successfully treated before the onset of irreversible brain damage.6 However, if left untreated, 84% will develop KP when followed up long-term.7
Symptoms
Symptoms of Korsakoff’s psychosis include:
- Impaired recall of old information (retrograde amnesia)1,4
- Lack of insight4
- False recollections/fictions: “confabulation”1
- Poor acquisition of new information (anterograde amnesia)1
- Disorientation in space and time4
- Poor recognition of familiar people1
Of the 84% who developed Korsakoff’s Psychosis:3
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References
1. Kopelman MD, et al. Alcohol Alcohol 2009;44:148–154.
2. Smith I, Hillman A. Adv Psychiatr Treat 1999; 5: 271–278.
3. Thomson AD et al. Alcohol Alcohol 2002. 37; 513-521.
4. Thomson AD, et al. Neuropsychol Rev 2012;22:81–92.
5. Sechi G, Serra A. Lancet Neurol 2007;6:442–455.
6. Thomson AD, et al. Alcohol Alcohol 2008;43:180–186.
7. Thomson AD, Cook CCH. Alcohol & Alcoholism Vol. 32, No. 3, pp. 207-209, 1997.
8. Alcohol and brain damage in adults. Royal College of Psychiatrists College Report CR185, May 2014.
9. Public Health Wales. Evidence-based profile of alcohol related brain damage in Wales. March 2015.
KKI/GB/PAB/0281 November 2023