Korsakoff psychosis, also called Korsakoff syndrome, can be defined as a severe and chronic memory disorder that is part of Wernicke-Korsakoff syndrome. Korsakoff psychosis is normally caused by Wernicke encephalopathy, a disorder that can occur when a person has a thiamine or vitamin B1 deficiency. This deficiency can develop in individuals experiencing substance use disorder, eating disorders, or other dietary deficiencies. Symptoms of Korsakoff psychosis may include amnesia, tremors, coma, vision problems, and disorientation. 

After Wernicke-Korsakoff syndrome has been diagnosed, treatment may include a variety of techniques, depending on the root cause of the disorder and the intensity of the Korsakoff psychosis symptoms. For individuals who experience this disorder because of substance use or an eating disorder, working with a mental health professional to address underlying concerns may be beneficial. 

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What is Korsakoff psychosis?

Korsakoff psychosis, also known as Wernicke-Korsakoff syndrome (WKS), is generally described as a neurological disorder caused by a thiamine deficiency. Wernicke-Korsakoff syndrome can be thought of as two separate conditions that are often seen together. 

Wernicke encephalopathy can be seen as the acute phase of the condition and is typically characterized by confusion, ataxia (loss of muscle coordination), and ophthalmoplegia (paralysis of the eye muscles). If left untreated, it can progress to Korsakoff psychosis.

Korsakoff psychosis is a chronic and often permanent condition that usually impacts the central nervous system and can be characterized by severe memory problems, particularly anterograde amnesia and retrograde amnesia, which generally refer to the inabilities to create new memories and remember past memories. 

Individuals with severe cases of Korsakoff psychosis may also confabulate (fill in memory gaps with false information) and have trouble learning new information.

Individuals with an alcohol use disorder, chronic infections, or an eating disorder like bulimia may experience Wernicke-Korsakoff syndrome. These risk factors may inhibit the body from absorbing thiamine, also called vitamin B1. Vitamin B1 tends to be essential for proper brain function, particularly in glucose metabolism. 

A lack of vitamin B1 can lead to brain cell damage, especially in regions important for memory and learning. This damage is usually believed to be the underlying cause of the memory problems and neurological symptoms often seen in Korsakoff psychosis.

Symptoms of Korsakoff psychosis

After developing Wernicke-Korsakoff syndrome, a person may experience various mental and physical symptoms. The initial thiamine deficiency may trigger Wernicke encephalopathy (WE), which usually involves symptoms like the following: 

• Low blood pressure: In general, thiamine is an important part of the autonomic nervous system, which typically regulates the heart rate, blood pressure, and digestive functions. In people with Wernicke encephalopathy, these may be impacted due to the lack of thiamine. 
• Loss of muscle coordination: Damage to the brain and nerve cells in various regions may cause ataxia, or loss of muscle control, as well as other muscle-related disorders. 
• Hypothermia: Damage to the brain during Wernicke encephalopathy can disrupt the thermoregulation process, contributing to an impaired ability to maintain a normal body temperature.
• Confusion: Wernicke encephalopathy may involve damage to the thalamus and hypothalamus, which are structures deep in the brain. Damage to these areas can disrupt normal information processing functions and lead to confusion.
• Vision problems: The oculomotor nerves, which typically control eye movement, may be damaged due to WE. Damage to these nerves can result in symptoms like nystagmus (involuntary eye movements), gaze palsy (inability to move the eyes in certain directions), and ophthalmoplegia (paralysis of the eye muscles), which can cause diplopia (double vision) and difficulty focusing.

As Wernicke encephalopathy progresses and symptoms become more severe, it can lead to Korsakoff psychosis. Symptoms of Korsakoff psychosis may include those discussed below: 

• Anterograde amnesia: Anterograde amnesia can be defined as the inability to form new memories. Although scientists are unsure about how Korsakoff psychosis may cause amnesia, it is believed that damage to the brain due to the lack of thiamine could disrupt signaling and memory storage, which may play a central role.
• Retrograde amnesia: Individuals with retrograde amnesia may not be able to remember events in the past. 
• Confabulation: A person with Korsakoff psychosis may unintentionally create or substitute memories in a process called confabulation. 
• Other cognitive impairments: Brain damage may also cause other impairments for individuals with Korsakoff psychosis, including reduced short-term memory formation and disorientation. 

While symptoms may vary from person to person, getting treatment as early as possible may be the key to improving memory-related symptoms. Although there are treatments available to reverse the physical symptoms, rehabilitating amnesia can be more challenging. Working with a team of mental health professionals and doctors may play a key role in improving Wernicke-Korsakoff symptoms over time. 

Diagnosis and treatment of Wernicke-Korsakoff syndrome

Getting a diagnosis of Wernicke-Korsakoff syndrome (WKS) can involve working closely with a doctor or mental health professional in a clinical setting. When someone is experiencing the signs and symptoms of WKS and has other risk factors present, such as alcohol use or an eating disorder, a doctor may test a patient’s thiamine levels. A doctor may also use an MRI to rule out other disorders. However, brain damage may not be visible in the early stages. 

If a patient is diagnosed with WKS, addressing the causes and increasing a person’s thiamine levels are often the first steps. A doctor may begin treatment by adding a thiamine supplement to reverse or lessen the impact of Wernicke encephalopathy. When detected early, thiamine supplementation can be effective. However, once a patient begins to lose memory as a result of a lack of vitamin B1, it can be more challenging to recover.

After the initial treatment and recovery, it may be necessary for a person to undergo mental health treatment to treat the underlying cause of WKS. Therapy techniques, such as cognitive behavioral therapy, can be effective at treating substance use disorders and eating disorders. A therapist can help individuals develop coping strategies and find a support network to manage the mental health conditions that may lead to Wernicke encephalopathy and Korsakoff psychosis. 

Coping strategies and support for Korsakoff psychosis

Although living with WKS can be challenging and may impact a person’s life in many ways, various treatments and coping strategies can improve patient outcomes over time. In terms of regaining memory loss associated with WKS, promising research generally centers on reteaching process-oriented memory through memory rehabilitation strategies. These strategies can help a person regain some of their daily autonomy and independence. However, ongoing support may be required for declarative or fact-based knowledge. 

For individuals recovering from Korsakoff psychosis, joining a support group or connecting with a family counselor may be beneficial. By developing a support network, a person with Korsakoff syndrome can begin to learn strategies from other individuals who are at varying stages of recovery. For many with WKS, family members serve as primary caregivers, especially in cases involving significant memory loss. Working with a family therapist in conjunction with other treatments may relieve any interpersonal family stress associated with the effects of WKS. 

After experiencing Korsakoff syndrome, individuals may also benefit from several lifestyle changes to support their recovery and overall well-being. Eating foods rich in vitamins and minerals, including thiamine, can support brain health and overall recovery. It can be important to maintain a healthy weight and avoid excessive alcohol consumption, which can further damage the brain. Using various structures and memory aids to reduce confusion and improve productivity may be effective as well. 

Long-term care for Korsakoff psychosis

Individuals with Korsakoff psychosis due to substance use disorder or an eating disorder may be able to reduce symptoms and achieve long-term recovery. Studies show that around 75% of individuals can improve symptoms of Korsakoff psychosis, and early detection and treatment may improve patient outcomes. Studies also show that while a person’s memory may not fully recover, their life expectancy may not change as a result of the disorder. 

Treating the underlying cause of WKS is usually key to preventing continued damage due to the syndrome. Online therapy can be effective in treating both substance use disorders and eating disorders. An online therapist or other mental health professional may use a variety of techniques, including cognitive behavioral therapy, to reframe negative thought patterns and help a person recover. 

Finding a therapist who is a good fit in a nearby location can be challenging. Online therapy generally offers the flexibility to work with a therapist from anywhere, rather than having to make the time to visit a brick-and-mortar office each week. Users can also switch therapists as needed until they find the right fit.

Takeaway

Korsakoff psychosis is a severe mental health condition usually caused by a lack of vitamin B1 (thiamine). This deficiency typically stems from an eating disorder or alcohol use disorder, both of which can negatively impact thiamine levels. Korsakoff syndrome is normally treated with vitamin B1 supplementation and memory rehabilitation tasks. After the initial treatment, online therapy may be an effective way to address the underlying cause of Korsakoff psychosis, and it may help manage the symptoms of memory loss over time.