Delirium tremens (DT) is a life threatening manifestation of alcohol withdrawal that occurs in about 5% of patients. the presentation of alcohol withdrawal syndrome (AWS) often overlaps with the acute medical problem and compounded by the underlying co-morbidities. Appropriate therapy administered in a timely fashion by clinicians with a high index of suspicion in patients with alcohol dependence can prevent DT.

This retrospective case series was undertaken to understand the clinical features and management decisions of patients presenting with alcohol related disorders (ARD) in Singapore.

To describe the difference in demographics, clinical presentation, co-morbidity, length of stay, management decision (pharmacotherapy administered, psychosocial intervention, resource allocation) and outcome of DT versus mild to moderate AWS.

28 patients with a total of 31 visits were referred to the Department of Psychological Medicine of Tan Tock Seng Hospital from 1 Jan 2011 to 30 Oct 2011 for the management of ARD. These records were obtained from computer generated hospital database for case description.

Majority of patients presenting with ARD are male and of Indian descent. Most have significant concurrent co-morbidity. the mean age of patients who develop DT is higher than those with mild to moderate AWS.

A simple assessment of the patient's acute presentation and past medical illness which may be easily evaluated in clinical settings can allow clinicians to readily identify patients who are at high risk of developing DT and reserve more intensive therapies for the selected cases.