07ee_Substance-Induced Disorders Flashcards
Substance-Induced Disorders:
Three Classes
Substance intoxication
Substance Withdrawal
Substance/Medication induced Mental Disorders
Substance/Medication-Induced Mental Disorders:
Three Types
Psychotic disorder
Depressive disorder
Neurocognitive disorder
Substance/Medication-Induced Mental Disorders:
Common Diagnostic Criteria
Symptomatic presentation of a mental disorder
Develops within one month of substance intoxication or withdrawal or of taking medication that is capable of producing the disorder
Does not occur only during the course of delirium
Substance/Medication induced Mental Disorders:
Overview
Develops in the context of the effects of substances of abuse, medications, or toxins
Potentially severe, usually temporary, but sometimes persisting central nervous system syndromes
Alcohol-Induced Disorders:
Overview
Alcohol is associated with all of the substance-induced disorders except OCD
Alcohol intoxication
Alcohol withdrawal
Alcohol withdrawal delirium
Alcohol-induced major neurocognitive disorder
Alcohol-induced sleep disorder
Alcohol Intoxication:
Maladaptive behavioral and psychological changes, and at least one of 5 symptoms
Slurred speech
Incoordination
Unsteady gait
Nystagmus
Impaired attention or memory
Stupor or coma
Alcohol Withdrawal:
Diagnostic Criteria
2+ symptoms that occur within several hours to a few days following cessation or reduction
Autonomic hyperactivity (sweating, tachycardia)
Hand tremor
Insomnia
Nausea or vomiting
Transient delusions or hallucinations
Anxiety
Psychomotor agitation
Generalized tonic-clonic seizures
Alcohol Withdrawal Delirium
Prominent disturbances in attention, awareness, and cognition
Autonomic hyperactivity
Vivid hallucinations
Delusions
Agitation
Alcohol-Induced Major Neurocognitive Disorder:
Overview
Significant decline in one or more cognitive domains
Interferes with independence and at everyday activities
Alcohol-Induced Major Neurocognitive Disorder:
To specifiers
Nonamnestic-confabulary type
Amnestic-confabulatory type: Korsakoff syndrome
Korsakoff syndrome
Anterograde and retrograde amnesia
Confabulation to compensate for memory losss
*Linked to thiamine deficiency
Alcohol-Induced Sleep Disorder:
Overview
Usually Insomnia
Results from either intoxication or withdrawal
Alcohol-Induced Sleep Disorder:
Intoxication symptoms
Immediate sedation
Increased stage 3 and 4 sleep
Reduced REM sleep followed by:
increased wakefulness
increased REM sleep (vivid anxiety-arousing dreams)
reduced 3 and 4 sleep
Alcohol-Induced Sleep Disorder:
Withdrawal symptom profile
Severe disruption and sleep continuity with vivid dreams
Stimulant Intoxication:
(Amphetamine-type drugs and cocaine)
Essential Features
Euphoria or affect of blunting
Hypervigilance
Anxiety or anger
Impaired judgment
2+ characteristic symptoms during or shortly after drug use needed for diagnosis
Stimulant Intoxication:
Characteristic symptoms
Tachycardia or bradycardia
Pupillary dilation
Elevated or lowered blood pressure
Perspiration or chills
Nausea or vomiting
Weight loss
Psychomotor agitation or retardation
Muscular weakness
Respiratory depression
Cardiac arrhythmias
Confusion
Seizures
Coma
Stimulant Withdrawal:
Diagnositc Criteria
At least 2 of 5 physiological changes that occur within a few hours to several days after cessation or reduction of prolonged stimulant use
Stimulant Withdrawal:
“Crash”
Intense lethargy
Depression
Increased appetite
Symptoms of Sedative, Hypnotic, or Anxiolytic Intoxication
Slurred speech
Lack of coordination
Unsteady gait
Nystagmus
Impair cognition
Stupor or coma
Opioid Intoxication Symptoms
Pupillary constriction
Drowsiness or coma
Slurred speech
Impaired attention or memory
Opioid Withdrawal Symptoms
Dysphoric mood
Nausea or vomiting
Muscle aches
Lack cremation or rhinorrhea
Pupillary dilation
Sweating
Diarrhea
Fever
Insomnia
Inhalant Intoxication Symptoms
E.g., toluene or gasoline
Dizziness
Nystagmus
Lack of coordination
Slurred speech
Unsteady gait
Lethargy
Depressed reflexes
Psychomotor retardation
Tremor
Generalized muscle weakness
Blurred vision
Stupor or coma
Euphoria
Tobacco Withdrawal:
Diagnostic Criteria
4+ symptoms within 24 hours of abrupt cessation or reduction:
Irritability or anger
Anxiety
Impaired concentration
Increased appetite
Restlessness
Depressed mood
Insomnia
Stimulant Withdrawal:
Characteristic Symptoms
Fatigue
Vivid unpleasant dreams
Insomnia/hypersomnia
Increased appetite
Psychomotor agitation or retardation
