Dependence Syndrome

Question 1

DEFINITIONS

Answer 1

• cluster of physiological, behavioural and cognitive phenomena which the use of substance takes a much higher priority than other behaviours that once had greater value.
• overpowering desire to use psychoactive substance
• rapid reappearance of features after period of abstinence.

Question 2

DIAGNOSTIC GUIDELINES:

≥3 of following over previous year:

Answer 2

a) strong desire/compulsion to take substance.
b) difficulties controlling substance-taking behaviour.
c) evidence of withdrawal/use of same substance to prevent or alleviate withdrawal syndrome
d) evidence of tolerance

e) progressive neglect of alternative pleasures and interest
- due to psychoactive substance use/increased time to recover from use

f) persisting use despite awareness of clear evidence of harmful effects of substance use.

Question 3

PSYCHOTIC DISORDERS

Answer 3

• cluster of psychotic phenomena during/immediately after psychoactive substance use
• vivid hallucinations(usually auditory and often more than one modality)
• ideas of reference
• psychomotor disturbances
• abnormal affect
• some degree of clouding consciousness
• usually resolves at least partially within 1/12 and fully within 6/12
• onset within 48h of usage, if >2w after, late-onset.

Question 4

Ddx

Answer 4

Mood disorders, schizophrenia, paranoid/schizoid-like personality disorder

Question 5

ACUTE INTOXICATION

Answer 5

Disturbances in cognition, consciousness, perception, affect or behaviour, or other psychopathological functions and responses wout persistent use.

-transient and usually complete recovery