Psychoactive substance use disorders

Question 1

F10-F19

Answer 1

• mental an behavioural disorders due to psychoactive substance use
• ICD-10

Question 2

Harmful use

Answer 2

• a pattern of substance use that is causing damage to physical or mental health
• should not be diagnosed if dependence seen
• ICD10-where actual harm is caused to drinker physically or mentally but no dependence
• DSM-4- upholds the concept of abuse which refers to maladaptive use

Question 3

Dependence

Answer 3

• Edward and Gross
• narrowed repertoire
• salience of alcohol seeking behaviour
• increased tolerance
• repeated withdrawals
• drinking to prevent or relieve withdrawals
• subjective awareness of compulsion
• reinstatement after abstinence

Question 4

Alcohol abuse

Answer 4

• DSM4
• despite problems with social, occupational, physical and psychological domains
• in hazardous situations
• at least one month, recurring over a longer period
• not dependent on alcohol

Question 5

ICD 10- alcohol dependence

Answer 5

• at least 3 of the following in last 12 months
  1. intense desire to drink ETOH
  2. difficulty controlling the onset, termination and level of drinking
  3. experiencing withdrawal symptoms is ETOH is not taken
  4. use of ETOH to relieve from withdrawal symptoms
  5. tolerance as evidenced by the need to escalate dose over time to achieve same effect
  6. salience- neglecting alternate forms of leisure or pleasure in life
  7. the narrowing personal repertoire of alcohol use

Question 6

DSM-4 alcohol dependence

Answer 6

-requires at least 3 in the past month
1. consuming ETOH for a longer period and larger amounts than intended
2/ unsuccessful attempts to cut down
3. experiencing withdrawal
4. use of ETOH to prevent withdrawal
5. tolerance of at least 50% from the start
6.salience
7. failure to role obligations and physical health
8. giving up other pleasures
9. continued use despite harm