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Intermittent Explosive Disorder 467 than 30 minutes and commonly occur in response to a minor provocation by a close intimate or associate. Individuals with intermittent explosive disorder often have less severe epi-' sodes of verbal and/ or nondamaging, nondestructive, or noninjurious physical assault (Cri-terion A1) ... |
468 Disruptive, Impulse-Contr ol, and Conduct Disorders Genetic and physiological. First-deg ree relatives of individuals with intermittent ex plosive disorder are at increased risk for intermittent explosive disorder, and twin studies have demonstrated a substantial genetic influence for impulsive aggression. Researc... |
Conduct Disorder 469 Delirium, major neurocognitive disorder, and personality change due to another med ical condition, agressive type. A diagnosis of intermittent explosive disorder should not be made when aggressive outbursts are judged to result from the physiological effects of an other diagnosable medical condit... |
470 Disruptive, Impulse-Contr ol, and Conduct Disorders 4. Has been physically cruel to people. 5. Has been physically cruel to animals. 6. Has stolen while confronting a victim (e. g., mugging, purse snatching, extortion, armed robbery). 7. Has forced someone into sexual ac tivity. Destruction of Property 8. Has delib... |
Conduct Disorder 471 Unconcerned about performance: Does not show concern about poor/problem atic perfor'(Tlance at school, at work, or in other important activities. The individual does not put forth the effort necessary to perform well, even when expectations are clear, and typically blames others for his or her poo... |
472 Disruptive, Impulse-Contr ol, and Conduct Disorders Although the validity of self-report to assess the presence of the specifier has been sup ported in some resear ch contexts, individuals with conduct disorder with this specifier may not readily admit to the traits in a clinical interview. Thus, to assess the cri... |
Conduct Disorder 473 case and respond with aggression that they then feel is reasonable and justified. Person ality features of trait negative emotionality and poor self-control, including poor frustra tion tolerance, irritability, temper outbursts, suspiciousness, insensitivity to punishment, thrill seeking, and rec... |
474 Disruptive, Impulse-Control, and Conduct Disorders Genetic and physiological. Conduct disorder is influenced by both genetic and envi ronmental factors. The risk is increased in children with a biological or adoptive parent or a sibling with conduct disorder. The disorder also appears to be more common in children... |
Conduct Disorder 475 thority figures (e. g., parents, teachers, work supervisors ). The behaviors of oppositional defiant disordeq ue typically of a less severe nature than those of individuals with conduct disorder and do not include aggression toward individuals or animals, destruction of property, or a pattern of th... |
476 Disruptive, Impulse-Contr ol, and Conduct Disorders Antisocial Personal ity Disorder Criteria and text for antisocial personality disorder can be found in the chapter "Person ality Disorders. " Because this disorder is closely connected to the spectrum of "external izing" conduct disorders in this chapter, as wel... |
Pyromania 477 they may derive satisfaction from the resulting property destruction. The behaviors may lead to property \damage, legal consequences, or injury or loss of life to the fire setter or to others. Individuals who impulsively set fires (who may or may not have pyromania) often have a current or past history of... |
478 Disruptive, Impulse-Contr ol, and Conduct Disorders Klep toman ia Dia gnosti c Criteria 312. 32 (F63. 3 ) A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value. B. Increasing sense of tension immediately before committing the theft. C. Pleasure, gr... |
Other Specified Disruptive, Impulse-Contr ol, and Conduct Disorder 479 Risk and Prognos tic Facto rs Genetic and phsiological. There are no controlled family history studies of kleptoma nia. However, first-degree relatives of individuals with kleptomania may have higher rates of obsessive-compulsive disorder than the ... |
480 Disruptive, Impulse-Contr ol, and Conduct Disorders Unspecified Disr uptive, Impulse-Contr ol, and Cond uct Disorder 312. 9 (F91. 9) This category applies to presentations in which symptoms characteristic of a disruptive, impulse-control, and conduct disorder that cause clinically significant distress or impair me... |
Substan ce-Related and Addictive Disorders The sub stance-related disorders encompass 10 separate classes of drugs: alco hol; caffeine; cannabis; hallucinogens (with separate categories for phencyclidine [or sim ilarly acting arylcyclohexylamines] and other hallucinogens); inhalants; opioids; sedatives, hypnotics, an... |
-'=" TABLE 1 Diagnoses associated with substance class co N Obsessive-Sub-Sub-De pres-compulsiv e Sexual Neur o-Subs tance stance stance Psychotic Bipolar sive Anxiety and related Sleep dysfu nc-cogn itive use into xi-with-disorders disorders disorders disorders disorder s disorders tions Delirium disor ders disor ders... |
Substance Use Disorders 483 Subs tance-Rela ted Dis order s Substance Use Dis order s Features The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance de spite significant substance-related problems... |
484 Substance-Related and Addictive Disorders Pharmacological criteria are the final grouping (Criteria 10 and 11). Tolerance (Crite rion 10) is signaled by requiring a markedly increased dose of the substance to achieve the desired effect or a markedly reduced effect when the usual dose is consumed. The degree to whi... |
Substance Use Disorders 485 Recor ?ing Procedures for Substance Use Disorders \ The clinician should use the code that applies to the class of substances but record the name of the specific substance. For example, the clinician should record 30 4. 10 (F13. 20) moderate alprazolam use disorder (rather than moderate seda... |
486 Substance-Related and Addictive Disorders sustained, or "chronic," intoxications. For example, moderate cocaine doses may initially produce gregariousness, but social withdrawal may develop if such doses are frequently repeated over days or weeks. When used in the physiological sense, the term intoxication is broad... |
Substance-Induced Disorders 487 In addition, normal functioning in the presence of high blood levels of a substance sug gests consideraqle tolerance. Developme nt and Course Individuals ages 18-24 years have relatively high prevalence rates for the use of virtually every substance. Intoxication is usually the initial ... |
488 Substance-Related and Addictive Disorders A. The disorder represents a clinically significant symptomatic presentation of a relevant mental disorder. B. There is evidence from the history, physical examination, or laboratory findings of both of the following: 1. The disorder developed during or within 1 month of a ... |
Substance-Induced Disorders 489 of the medicatio ns. When symptoms are only observed during a delirium (e. g., alcohol withdrawal delirium), the mental disorder should be diagnosed as a delirium, and the psychiatric syndrome occurring during the delirium should not also be diagnosed sepa rately, as many symptoms (incl... |
490 Substance-Related and Addictive Disorders Func tional Con seq uences of Substa nce/M edication Induced Mental Disorder s The same consequences related to the relevant independent mental disorder (e. g., suicide attempts) are likely to apply to the substance/medication-induced mental disorders, but these are likely... |
Alcohol Use Disorder 491 3. A great deal of time is spent in activities necessar y to obtain alcohol, use alcohol, or recover from its effects. 4. Craving, or a strong desire or urge to use alcohol. 5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. 6. Continued ... |
492 Substance-Related and Addictive Disorders Specifi ers "In a controlled environment" applies as a further specifier of remission if the individual is both in remission and in a controlled environment (i. e., in early remission in a controlled environment or in sustained remission in a controlled environmen t). Examp... |
Alcohol Use Disorder 493 creased rate among those who drink very heavily. These factors, along with marked increases in levels of triglycerides and low-density lipoprotein cholesterol, contribute to an elevated risk of heart disease. Peripheral neuropathy may be evidenced by muscular weakness, paresthesias, and decreas... |
494 Substance-Related and Addictive Disorders Among adolescents, conduct disorder and repeated antisocial behavior often co-occur with alcohol-and with other substance-related disorders. While most individuals with al cohol use disorder develop the condition before age 40 years, perhaps 10% have later onset. Age-relat... |
Alcohol Use Disorder 495 Polymorphisms of genes for the alcohol-metabolizing enzymes alcohol dehydroge nase and aldehxde dehydrogenase are most often seen in Asians and affect the response to alcohol. When consuming alcohol, individuals with these gene variations can experience a flushed face and palpitations, reactio... |
496 Substance-Related and Addictive Disorders ing can accompany gastritis, and hepatomegaly, esophageal varices, and hemorrhoids may reflect alcohol-induced changes in the liver. Other physical signs of heavy drinking include tremor, unsteady gait, insomnia, and erectile dysfunction. Males with chronic alcohol use dis... |
Alcohol Intoxication 497 may relate to alcohol use disorder as well. At least a part of the reported association between depression and rpoderate to severe alcohol use disorder may be attributable to temporary, al cohol-induced comorbid depressive symptoms resulting from the acute effects of intoxication or withdrawal... |
498 Substance-Related and Addictive Disorder s observed at different time points. Evidence of mild intoxication with alcohol can be seen in most individuals after approximat ely two drinks (each standard drink is approximately 10-12 grams of ethanol and raises the blood alcohol concentration approximately 20 mg/ d L). ... |
Alcohol Withdrawal 499 Diagno stic Markers Intoxication is usually established by observing an individual's behavior and smelling alcohol on the breath. The degree of intoxication increases with an individual's blood or breath alcohol level and with the ingestion of other substances, especially those with sedating effe... |
500 Substance-Related and Addictive Disorders D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance. Specify if: With perceptual disturbances : This specifier applies in the rare ins... |
Alcohol Withdrawal 501 Preva lence It is estimated that approximately 50% of middle-class, highly functional individuals with alcohol use disorder have ever experienced a full alcohol withdrawal syndrome. Among individuals with alcohol use disorder who are hospitalized or homeless, the rate of al cohol withdrawal may ... |
502 Substance-Related and Addictive Disorders Oth er Alcoh ol-Induc ed Disor der s The following alcohol-induced disorders are described in other chapters of the manual with disorders with which they share phenomenology (see the substan ce/medication-induced mental disorders in these chapter s): alcohol-induced psychot... |
Unspecified Alcohol-Related Disorder 503 drawal. While the symptoms are identical to those of independent mental disorders (e. g., psychoses, majqr depressive disorder), and while they can have the same severe conse quences (e. g., suicide attempts), all alcohol-induced syndromes other than alcohol induced neurocogni... |
504 Substance-Related and Addictive Disorders 3. Excitement. 4. Insomnia. 5. Flushed face. 6. Diuresis. 7. Gastrointestinal disturbance. 8. Muscle twitching. 9. Rambling flow of thought and speech. 10. Tachycardia or cardiac arrhythmia. 11. Periods of inexhaustibility. 12. Psychomotor agitation. C. The signs or symptom... |
Caffeine Intoxication 505 Preva lence The prevalence f caffeine intoxication in the general population is unclear. In the United States, approximately 7% of individuals in the population may experience five or more symp toms along with functional impairment consistent with a diagnosis of caffeine intoxication. Dev elo... |
506 Substance-Related and Addictive Disorders Comorbid ity Typical dietary doses of caffeine have not been consistently associated with medical prob lems. However, heavy use (e. g., >400 mg) can cause or exacer bate anxiety and somatic symptoms and gastrointestinal distress. With acute, extremely high doses of caffein... |
Caffeine Withdrawal 507 The probability and severity of caffeine withdrawal generally increase as a function of usual daily caffine dose. However, there is large variability among individuals and within individuals across different episodes in the incidence, severity, and time course of withdrawal symptoms. Caffeine wi... |
508 Substance-Related and Addictive Disorders pation. These external environmental circumst ances may precipitate a withdrawal syn drome in vulnerable individ uals. Genetic and physiological factors. Genetic factors appear to increase vulnerability to caffeine withdrawal, but no specific genes have been identified. Co... |
Unspecified Caffeine-Rela ted Disorder 509 . Unspecifi ed Caffeine-Rela ted Disorder \ 292. 9 (F15. 99) This category applies to presentations in which symptoms characteristic of a caffeine related disorder that cause clinically significant distress or impairment in social, occupa tional, or other important areas of ... |
510 Substance-Related and Addictive Disorders b. Cannabis (or a closely related substance) is taken to relieve or avoid withdrawal symptoms. Spec ify if: In early remission: After full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder have been met for at least 3 mon... |
Cannabis Use Disorder 511 Synthetic oral formulations (pill/ capsules) of delta-9-tetrahydrocannabinol ( delta-9-THC) are availale by prescription for a number of approved medical indications (e. g., for nausea and vomiting caused by chemotherapy; for anorexia and weight loss in individuals with AIDS). Other synthetic ... |
512 Substance-Related and Addictive Disorders tolerance and withdrawal will naturally occur and should not be used as the primary cri teria for determining a diagnosis of a substance use disorder. Although medical uses of cannabis remain controversial and equivocal, use for medical circumstances should be considered w... |
Cannabis Use Disorder 513 Dev elopm ent and Cou rse The onset of canhabis use disorder can occur at any time during or following adolescence, but onset is most commonly during adolescence or young adulthoo d. Although much less frequent, onset of cannabis use disorder in the preteen years or in the late 20s or older ca... |
514 Substance-Related and Addictive Disorders or internalizing disorders during childhood or adolescence. Youths with high behavioral disinhibition scores show early-onset substance use disorders, including cannabis use dis order, multiple substance involvement, and early conduct problem s. Environmental. Risk factors... |
Cannabis Use Disorder 515 chotic episode, can exacerbate some symptoms, and can adversely affect treatment of a major psychotic \llness. Differ ential Diagnosis Non problematic use of cannabis. The distinction between nonproblematic use of can nabis and cannabis use disorder can be difficult to make because social, be... |
516 Substance-Related and Addictive Disorders effects of cannabis involve the respiratory system, and chronic cannabis smokers exhibit high rates of respiratory symptoms of bronchitis, sputum production, shortness of breath, and wheezing. Can nabis Intoxica tion Diagno stic Criteria A. Recent use of cannabis. B. Clinic... |
Cannabis Withdrawal 517 dysphoria, or social withdrawal occurs. These psychoact ive effects are accompanied by two or more of te following signs, developing within 2 hours of cannabis use: conjuncti val injection, increased appetite, dry mouth, and tachycardia (Criterion C). Intoxication develops within minutes if the... |
518 Substance-Related and Addictive Disorders 1. Irritability, anger, or aggression. 2. Nervousness or anxiety. 3. Sleep difficulty (e. g., insomnia, disturbing dreams). 4. Decreased appetite or weight loss. 5. Restlessness. 6. Depressed mood. 7. At least one of the following physical symptoms causing significant disco... |
Unspecified Cannabis-Re lated Disorder 519 Risk and Prognos tic Facto rs \ Environmental. Most likely, the prevalence and severity of cannabis withdrawal are greater among heavier cannabis users, and particularly among those seeking treatment for cannabis use disorders. Withdrawal severity also appears to be positively... |
520 Substance-Related and Addictive Disorders Hal luci nogen-Rela ted Disor der s Phencyclidine Use Disorder Other Hallucinogen Use Disorder Phencyclidine Intoxication Other Hallucinogen Intoxication Hallucinogen Persisting Percept ion Disorder Other Phencyclidine-Induced Disorders Other Hallucino gen-Induced Disorders... |
Phencyclidine Use Disorder 521 Note: Withdrawal symptoms and signs are not established for phencyclidines, and so this criterion does not apply. (Withdrawal from phencyclidines has been reported in animals but not documented in human user s. ) Specify if: In early remission: After full criteria for phencyclidine use di... |
522 Substance-Rela ted and Addictive Disorders toms have not been clearly established in humans, and therefore the withdrawal criterion is not included in the diagnosis of phencyclidine use disorder. Asso ciated Featu res Suppo rting Diag nosis Phencyclidine may be detected in urine for up to 8 days or even longer at v... |
Other Hallucinogen Use Disorder 523 Differential Diagnosis \ Other substance use disorders. Distinguishing the effects of phencyclidine from those of other substances is important, since it may be a common additive to other substances (e. g., cannabis, cocaine ). Schizop hrenia and other mental disorders. Some of the e... |
524 Specify the particular hallucinogen. Specify if: Substance-Related and Addictive Disorders In early remission: After full criteria for other hallucinogen use disorder were previ ously met, none of the criteria for other hallucinogen use disorder have been met for at least 3 months but for less than 12 months (with... |
Other Hallucinogen Use Disorder 525 across types of hallucinogens. Some of these substances (i. e., LSD, MDMA) have a long half-life and extanded duration such that users may spend hours to days using and / or re covering from the effects of these drugs. However, other hallucinogenic drugs (e. g., DMT, salvia) are sho... |
526 Substance-Related and Addictive Disorders at onset with elevations in risk for other hallucinogen use disorder. However, patterns of drug consumption have been found to differ by age at onset, with early-onset ecstasy users more likely to be polydrug users than their later-onset counterp arts. There may be a dis p... |
Phencyclidine Intoxication Func tional Cons equenc es of Other Hall ucinogen Use Disorder 527 There is evidence for long-term neurotoxic effects of MDMA/ ecstasy use, including im pairments in memory, psychological function, and neuroendoc rine function; serotonin system dysfunction; and sleep disturbance; as well as ... |
528 Substance-Related and Addictive Disorders 3. Numbness or diminished responsiveness to pain. 4. Ataxia. 5. Dysarthria. 6. Muscle rigidity. 7. Seizures or coma. 8. Hyperacusis. D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including... |
Other Hallucinogen Intoxication 529 caine, or other stimulants; and anticholinergics, as well as withdrawal from benzodiaze pines. Nystagm\}s and bizarre and violent behavior may distinguish intoxication due to phencyclidine from that due to other substances. Toxicological tests may be useful in mak ing this distinct... |
530 Substance-Related and Addictive Disorders Prevalence The prevalence of other hallucinogen intoxication may be estimated by use of those sub stances. In the United States, 1. 8% of individuals age 12 years or older report using hallu cinogens in the past year. Use is more prevalent among younger individuals, with ... |
Hallucinogen Persisting Perception Disorder 531 Halluinogen Persisting Percep tion Disorder \ Dia gnostic Criteria 292. 8 9 (F16. 983) A. Following cessation of use of a hallucinogen, the reexperiencing of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e. g., geome... |
532 Substance-Rela ted and Addictive Disorders Dev elopm ent and Cou rse Little is known about the development of hallucinogen persisting perception disorder. Its course, as suggested by its name, is persistent, lasting for weeks, months, or even years in certain individuals. Risk and Prognostic Factors There is little... |
Unspecified Phencyclidine-Related Disorder 533 depressive disorder ("Depressive Disorders "); and other hallucinogen-induced anxiety disorder (" Anxi E\ty Disorders "). For other hallucinogen intoxication delirium, see the cri teria and discussion of delirium in the chapter "Neurocognitive Disorders. " These hallu ci... |
534 Substance-Related and Addictive Disorders 3. A great deal of time is spent in activities necessary to obtain the inhalant substance, use it, or recover from its effects. 4. Craving, or a strong desire or urge to use the inhalant substance. 5. Recurrent use of the inhalant subs tance resulting in a failure to fulfil... |
Inhalant Use Disorder 535 Spec ifier s This manual re Cognizes volatile hydrocarbon use meeting the above diagnostic criteria as inhalant use disorder. Volatile hydrocarbons are toxic gases from glues, fuels, paints, and other volatile compoun ds. When possible, the particular substance involved should be named (e. g.,... |
536 Substance-Related and Addictive Disorders in Native Americans and lowest in African Americans. Prevalence falls to about 0. 1% among Americans ages 18-29 years, and only 0. 02% when all Americans 18 years or older are con sidered, with almost no females and a preponderance of European Americans. Of course, in isol... |
Inhalant Use Disorder 537 the considerable expense of analyses make frequent biological testing for inhalants them selves impracti(\al. Func tional Cons equenc es of Inhalan t Use Disorder Because of inherent toxicity, use of butane or propane is not infrequently fatal. Moreover, any inhaled volatile hydrocarbons may ... |
538 Substance-Related and Addictive Disorders Comor bidi ty Individuals with inhalant use disorder receiving clinical care often have numerous other substance use disorders. Inhalant use disorder commonly co-occurs with adolescent con duct disorder and adult antisocial personality disorder. Adult inhalant use and inha... |
Inhalant Intoxication 539 Ass ocia ted Featu res Supporting Diagnosis Inhalant intox iction may be indicated by evidence of possession, or lingering odors, of in halant substances (e. g., glue, paint thinner, gasoline, butane light ers); apparent intoxica tion occurring in the age range with the highest prevalence of... |
540 Substance-Related and Addictive Disorders years); association with others known to use inhalants; membership in certain small com munities with prevalent inhalant use (e. g., some native or aboriginal communities, home less street children and adolescents ); or unusual access to certain inhalant substances. Other... |
Opioid Use Disorder 541 Opioid Use Disorder Dia gnostic Criteria A. A problematic pattern of opioid use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: 1. Opioids are often taken in larger amounts or over a longer period than ... |
542 Substance-Related and Addictive Disorders uals being maintained on a partial agonist, an agonist/antagonist, or a full antagonist such as oral naltrexone or depot naltrexone. In a controlled environment: This additional specifier is used if the individual is in an environment where access to opioids is restricted. ... |
Opioid Use Disorder 543 Associ ated Featu res Supp orting Diagnosis Opioid use disotder can be associated with a history of drug-related crimes (e. g., posses sion or distribution of drugs, forgery, burglary, robbery, larceny, receiving stolen goods). Among health care professionals and individuals who have ready acce... |
544 Substance-Related and Addictive Disorders a substance use disorder but may themselves be genetically determined. Peer factors may relate to genetic predisposi tion in terms of how an individual selects his or her environ ment. Culture-Rela ted Diagno stic Issues Despite small variations regarding individual criter... |
Opioid Use Disorder 545 in cellulitis, abscesses, and circular-appearing scars from healed skin lesions. Tetanus and Clostridium botul(num infections are relatively rare but extremely serious consequences of injecting opioids, especially with contaminated needles. Infections may also occur in other organs and include b... |
546 Substance-Related and Addictive Disorders are not seen in sedative-type withd rawal. Dilated pupils are also seen in hallucinogen intoxication and stimulant intoxication. However, other signs or symptoms of opioid withdrawal, such as nausea, vomiting, diarrhea, abdominal cramps, rhinorrhea, or lacri mation, are no... |
Opioid Withdrawal 547 use disorder is comorbid, the ICD-1 0-CM code is F11. 229. If there is no comorbid opi oid use disorder, then the ICD-1 0-CM code is F11. 929. \ For opioid intoxication with perceptual disturbances: If a mild opioid use disorder is comorbid, the ICD-10-CM code is F11. 122, and if a moderate or se... |
548 Substance-Related and Addictive Disorders 6. Diarrhea. 7. Yawning. 8. Fever. 9. Insomnia. C. The signs or symptoms in Criterion 8 cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The signs or symptoms are not attributable to another medical con... |
Opioid Withdrawal 549 Assoc iated Featu res Supp orting Diagno sis Males with opiold withdrawal may experience piloerection, sweating, and spontaneous ejaculations while awake. Opioid withdrawal is distinct from opioid use disorder and does not necessarily occur in the presence of the drug-seeking behavior associated w... |
550 Substance-Related and Addictive Disorders Unspecified Opioid-Rela ted Disorder 292. 9 (F11. 99) This category applies to presentations in which symptoms characteristic of an opioid related disorder that cause clinically significant distress or impairment in social, occupa tional, or other important areas of funct... |
Sedative, Hypnotic, or Anxiolytic Use Disorder 551 8. Recurrent sedative, hypnotic, or anxiolytic use in situations in which it is physically hazardou (e. g., driving an automobile or operating a machine when impaired by sedative, hypnotic, or anxiol ytic use). 9. Sedative, hypnotic, or anxiolytic use is continued desp... |
552 Substance-Related and Addictive Disorder s Specify current severity: 305. 40 (F13. 10) Mild: Presence of 2-3 symptoms. 304. 10 (F13. 20) Moderate: Presence of 4-5 symptoms. 304. 10 (F13. 20) Severe: Presence of 6 or more symptoms. Spec ifiers "In a controlled environment" applies as a further specifier of remission... |
Sedative, Hypnotic, or Anxiolytic Use Disorder 553 drawal. If these drugs are prescribed or recommended for appropriate medical purposes, and if they are u Sed as prescribed, the resulting tolerance or withdrawal does not meet the criteria for diagnosing a substance use disorder. However, it is necessary to determine w... |
554 Substance-Related and Addictive Disorders more prominent, and the individual may seek out multiple physicians to obtain sufficient supplies of the medicat ion. Tolerance can reach high levels, and withdrawal (including seizures and withdrawal delirium) may occur. As with many substance use disorders, sedative, hypn... |
Sedative, Hypnotic, or Anxiolytic Use Disorder 555 agents in the body). Urine tests are likely to remain positive for up to approximately 1 week after the use of lopg-acting substances, such as diazepam or flurazepam. Func tional Cons equences of Sedative, Hyp notic, or Anxi oiytic Use Disorder The social and interpers... |
556 Substance-Related and Addictive Disorders lap between sedative, hypnotic, or anxiolytic use disorder and antisocial personality dis order; depressive, bipolar, and anxiety disorders; and other substance use disorders, such as alcohol use disorder and illicit drug use disorders. Antisocial behavior and antisocial p... |
Sedative, Hypnotic, or Anxiolytic Withdrawal 557 mental disorder (Criterion D). Intoxication may occur in individuals who are receiving these substances by pre{>Cription, are borrowing the medication from friends or relatives, or are de liberately taking the substance to achieve intoxication. Asso ciated Featu res Sup... |
558 Substance-Related and Addictive Disorders 3. Insomnia. 4. Nausea or vomiting. 5. Transient visual, tactile, or auditory hallucinations or illusions. 6. Psychomotor agitation. 7. Anxiety. 8. Grand mal seizures. C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occ... |
Sedative, Hypnotic, or Anxiolytic Withdrawal 559 Asso ciated Featu res Supporting Diagnosis The timing and Severity of the withdrawal syndrome will differ depending on the specific substance and its pharmaco kinetics and pharmacodynamic s. For example, withdrawal from shorter-acting substances that are rapidly absorbed... |
560 Substance-Related and Addictive Disorders Other sedative-, hypnotic-, or anxiolyti c-induced disorders. Sedative, hypnotic, or anx iolytic withdrawal is distinguished from the other sedative-, hypnotic-, or anxiolytic induced disorders (e. g., sedative-, hypnotic-, or anxiolytic-induced anxiety disorder, with ons... |
Stimulant Use Disorder Stimul ant-Rela ted Disor der s Stimulant Use Disorder Stimulant Intoxication Stimulant Withdrawal Other Stimulant-Induced Disorders Unspecified Stimulant-Related Disorder 561 Stimulant Use Disor der Dia gnos tic Criteria A. A pattern of amphetamine-type substance, cocaine, or other stimulant use... |
562 Substance-Related and Addictive Disorders Note: This criterion is not consider ed to be met for those taking stimulant medica tions solely under appropria te medical supervision, such as medications for atten tion-deficit/hyperactivity disorder or narcolepsy. Speci fy if: In early remission: After full criteria f... |
Stimulant Use Disorder 563 Specifi ers "In a controlled environment" applies as a further specifier of remission if the individual is both in remission and in a controlled environment (i. e., in early remission in a controlled environment or in sustained remission in a controlled environment). Examples of these environ... |
564 Substance-Related and Addictive Disorders Individuals with acute intoxication may present with rambling speech, headache, tran sient ideas of reference, and tinnitus. There may be paranoid ideation, auditory halluci nations in a clear sensorium, and tactile hallucinations, which the individual usually recognizes ... |
Stimulant Use Disorder 565 among individuals in treatment occurs, on average, at approximately age 23 years. For pri mary methamphe tamine-primary treatment admissions, the average age is 31 years. Some individuals begin stimulant use to control weight or to improve performance in school, work, or athletics. This incl... |
566 Substance-Related and Addictive Disorders depending on dosage and metabolism. Hair samples can be used to detect presence of am phetamine-type stimulants for up to 90 days. Other laboratory findings, as well as physical findings and other medical conditions (e. g., weight loss, malnutrition; poor hygiene), are sim... |
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