07ee_Substance-Induced Disorders

Question 1

Substance-Induced Disorders:

Three Classes

Answer 1

Substance intoxication

Substance Withdrawal

Substance/Medication induced Mental Disorders

Question 2

Substance/Medication-Induced Mental Disorders:

Three Types

Answer 2

Psychotic disorder

Depressive disorder

Neurocognitive disorder

Question 3

Substance/Medication-Induced Mental Disorders:

Common Diagnostic Criteria

Answer 3

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

Question 4

Substance/Medication induced Mental Disorders:

Overview

Answer 4

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

Question 5

Alcohol-Induced Disorders:

Overview

Answer 5

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

Question 6

Alcohol Intoxication:

Maladaptive behavioral and psychological changes, and at least one of 5 symptoms

Answer 6

Slurred speech

Incoordination

Unsteady gait

Nystagmus

Impaired attention or memory

Stupor or coma

Question 7

Alcohol Withdrawal:

Diagnostic Criteria

Answer 7

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

Question 8

Alcohol Withdrawal Delirium

Answer 8

Prominent disturbances in attention, awareness, and cognition

Autonomic hyperactivity

Vivid hallucinations

Delusions

Agitation

Question 9

Alcohol-Induced Major Neurocognitive Disorder:

Overview

Answer 9

Significant decline in one or more cognitive domains

Interferes with independence and at everyday activities

Question 10

Alcohol-Induced Major Neurocognitive Disorder:

To specifiers

Answer 10

Nonamnestic-confabulary type

Amnestic-confabulatory type: Korsakoff syndrome

Question 11

Korsakoff syndrome

Answer 11

Anterograde and retrograde amnesia

Confabulation to compensate for memory losss

*Linked to thiamine deficiency

Question 12

Alcohol-Induced Sleep Disorder:

Overview

Answer 12

Usually Insomnia

Results from either intoxication or withdrawal

Question 13

Alcohol-Induced Sleep Disorder:

Intoxication symptoms

Answer 13

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

Question 14

Alcohol-Induced Sleep Disorder:

Withdrawal symptom profile

Answer 14

Severe disruption and sleep continuity with vivid dreams

Question 15

Stimulant Intoxication:
(Amphetamine-type drugs and cocaine)

Essential Features

Answer 15

Euphoria or affect of blunting

Hypervigilance

Anxiety or anger

Impaired judgment

2+ characteristic symptoms during or shortly after drug use needed for diagnosis

Question 16

Stimulant Intoxication:

Characteristic symptoms

Answer 16

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

Question 17

Stimulant Withdrawal:

Diagnositc Criteria

Answer 17

At least 2 of 5 physiological changes that occur within a few hours to several days after cessation or reduction of prolonged stimulant use

Question 18

Stimulant Withdrawal:

“Crash”

Answer 18

Intense lethargy

Depression

Increased appetite

Question 19

Symptoms of Sedative, Hypnotic, or Anxiolytic Intoxication

Answer 19

Slurred speech

Lack of coordination

Unsteady gait

Nystagmus

Impair cognition

Stupor or coma

Question 20

Opioid Intoxication Symptoms

Answer 20

Pupillary constriction

Drowsiness or coma

Slurred speech

Impaired attention or memory

Question 21

Opioid Withdrawal Symptoms

Answer 21

Dysphoric mood

Nausea or vomiting

Muscle aches

Lack cremation or rhinorrhea

Pupillary dilation

Sweating

Diarrhea

Fever

Insomnia

Question 22

Inhalant Intoxication Symptoms

E.g., toluene or gasoline

Answer 22

Dizziness

Nystagmus

Lack of coordination

Slurred speech

Unsteady gait

Lethargy

Depressed reflexes

Psychomotor retardation

Tremor

Generalized muscle weakness

Blurred vision

Stupor or coma

Euphoria

Question 23

Tobacco Withdrawal:

Diagnostic Criteria

Answer 23

4+ symptoms within 24 hours of abrupt cessation or reduction:

Irritability or anger

Anxiety

Impaired concentration

Increased appetite

Restlessness

Depressed mood

Insomnia

Question 24

Stimulant Withdrawal:

Characteristic Symptoms

Answer 24

Fatigue

Vivid unpleasant dreams

Insomnia/hypersomnia

Increased appetite

Psychomotor agitation or retardation