27th National Clinical Education Symposium Presentation Abstracts

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29 APRIL 2025, MONDAY
13:00-14:00 POSTER PRESENTATION SESSION-2

Management Of Mallory-Weiss Syndrome In A Psychiatry Clinic: A Case Report

Zeliha Büşra Durgungöz1, Canay Pamukcu1, Mehmet Buğrahan Gürcan1, Merih Altintas1

1. Department of Psychiatry, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey

DOI: 10.5080/kes27.abs145 Page 171
OBJECTIVE: Delirium tremens (DT) is a fatal complication of alcohol withdrawal syndrome (AWS). Early psychiatric intervention is crucial for prognosis. In alhocol use disorder (AUD) poor insight complicates treatment and increases comorbid risks. This case indicates the relation of insight and treatment resistance in AUD which can cause more fatal complications like DT and Mallory-Weiss Syndrome (MWS). CASE: Informed consent was obtained from the patient and relatives. A 43-year-old single male,university graduate, with a 20-year history of alcohol use. He consumes approximately 30 standard units of alcohol a day for 5 years. Patient admitted to the emergency clinic with melena, hematemesis, confusion and ataxia. CIWA-Ar score was 19. Detailed evaluation revealed MWS and DT. Benzodiazepine and Thiamine treatment started in emergency department. In fourth day of admission, patient was hemodynamicaly stabilized and transferred to psychiatry clinic for AUD management. Alcohol Use Awareness and Insight Scale score was 6,5 which indicates poor insight of illness. He was lack of knowledge about AUD. Insight intervention was conducted by taking inspiration from the problem-oriented, control-oriented, and environment-oriented sessions included in the brief intervention model. Cognitive restructuring helped the patient reassess his beliefs about alcohol use. By discharge, his insight had improved, and he showed openness to structured treatment DISCUSSION: Poor insight in AUD hinders treatment adherence. Timely recognition and intervention in AWS reduce complications and mortality.This case highlights the importance of psychoeducation and motivational techniques in AWS management. Future research should focus on standardized approaches to improving insight and their impact on relapse prevention and treatment adherence. Strengthening multidisciplinary collaboration among psychiatry and other clinics is essential for comprehensive AWS management.