trastornos inducidos por sustancias - criterios del dsm iv

8/11/2019 Trastornos Inducidos Por Sustancias - Criterios Del DSM IV

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Trastornos relacionados con sustancias

Trastornos relacionados con alcohol

1. Trastornos por consumo de alcohol

1. Dependencia de alcohol

2. Abuso de alcohol

2. Trastornos inducidos por el alcohol

1. Intoxicacin

2. Abstinencia

3. Delirium

4. Demencia

5. Trastorno amnsico

6. Trastorno psictico

7. Trastorno de ansiedad

8. Trastorno del sueo

9. Trastorno del estado de nimo

10. Trastorno relacionado con el alcohol no especificado


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Trastornos relacionados conalucingenos

1. Trastornos por consumo dealucingenos:

Dependencia de alucingenosAbuso de alucingenos

2. Trastornos inducidos por

alucingenosIntoxicacinTrastorno perceptivo persistenteDeliriumTrastorno psicticoTrastorno de ansiedad

Trastorno del estado de nimo

Trastornos relacionados conanfetaminas (o sustancias de accinsimilar)

1. Trastornos por consumo deanfetaminas

Dependencia de anfetaminasAbuso de anfetaminas

2. Trastornos inducidos por

anfetaminasIntoxicacinAbstinenciaDeliriumTrastorno psicticoTrastorno de ansiedadTrastorno del sueoTrastorno sexualTrastorno del estado de nimo


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Trastornos relacionados con cafena

1. Trastornos inducidos por cafenaIntoxicacinTrastorno de ansiedadTrastorno del sueoTrastorno relacionado con cafena no

especificado

Trastornos relacionados con cannabis

1. Trastornos por consumo de cannabisDependencia de cannabisAbuso de cannabis

2. Trastornos inducidos por cannabisIntoxicacin

DeliriumTrastorno psicticoTrastornos de ansiedadTrastorno relacionado con cannabis no

especificado

Trastornos relacionados con cocana

1. Trastornos por consumo de cocanaDependencia de cocanaAbuso de cocana

2. Trastornos inducidos por cocanaIntoxicacinAbstinenciaDelirium

Trastorno psicticoTrastorno del estado de nimoTrastorno de ansiedadTrastorno del sueoTrastorno sexualTrastorno relacionado con cocana no

especificado


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Trastornos relacionados con fenciclidina

1. Trastornos por consumo de fenciclidinaDependencia de fenciclidinaAbuso de fenciclidina

2. Trastornos inducidos por fenciclidina:

intoxicacin

delirium

trastorno psictico

trastorno del estado de nimo

trastorno de ansiedad

trastorno relacionado con fenciclidina no especificado

Trastornos relacionados con inhalantes

1. Dependencia de inhalantes2. Abuso de inhalantes3. Trastornos inducidos por inhalantes:

intoxicacin,delirium,

demencia,

trastorno psictico,

trastorno del estado de nimo y

trastorno relacionado con inhalantes no especificado

Trastornos relacionados con nicotina

1. Trastornos inducidos por nicotina: Dependencia denicotina2. Trastornos inducidos por nicotina:

abstinenciatrastorno relacionado con nicotina no especificado

Trastornos relacionados con opiceos

1. Trastornos por consumo de opiceosDependencia de opiceosAbuso de opiceos

2. Trastornos inducidos por opiceos:

intoxicacin,

abstinencia,

delirium,

trastorno psictico,

trastorno del estado de nimo,

trastorno del sueo,trastorno sexual y

trastorno relacionado con opiceos no especificado.


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Trastornos relacionados con sedantes, hipnticoso ansiolticos

1. Trastorno por consumo de sedantes, hipnticoso ansiolticos

Dependencia de sedantes,

hipnticos o ansiolticosAbuso de sedantes, hipnticos o ansiolticos

2. Trastornos inducidos por sedantes, hipnticoso ansiolticos:

intoxicacin,

abstinencia,

delirium,

demencia,

trastornos amnsicos,

trastorno psictico,

trastorno de ansiedad,

trastorno del sueo,trastorno del estado de nimo,

trastorno sexual y

trastorno relacionado con sedantes, hipnticos oansiolticos no especificado

Trastornos relacionados con varias sustancias

1. Dependencia de varias sustancias

Trastornos relacionados con otras sustancias (odesconocidas)

1. Trastorno por consumo de otras sustancias (odesconocidas)

Dependencia de otras sustanciasAbuso de otras sustancias

2. Trastornos inducidos por otras sustancias (odesconocidas):

intoxicacin,

abstinencia,

delirium,

demencia,

trastorno amnsico,

trastorno del estado de nimo,

trastorno sexual y

trastorno relacionado con otras sustancias (odesconocidas) no especificado


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The patient's maladaptive pattern of substance use leads to clinically important distress orimpairment as shown in a single 12-month period by 3 or more of the following:

-Tolerance, shown by either of:

- markedly increased intake of the substance is needed to achieve the same effect or-with continued use, the same amount of the substance has markedly less effect

-Withdrawal, shown by either of:-the substance's characteristic withdrawal syndrome or-the substance (or one closely related) is used to avoid or relieve withdrawal symptoms

-The amount or duration of use is often greater than intended.

-The patient repeatedly tries without success to control or reduce substance use.

-The patient spends much time using the substance, recovering from its effects or trying to obtain it.

-The patient reduces or abandons important social, occupational or recreational activities because ofsubstance use.

-The patient continues to use the substance, despite knowing that it has probably caused physical orpsychological problems.

Specify whether:With Physiological Dependence. There is evidence of tolerance or withdrawal (see above).Without Physiological Dependence.

Choose one or none to specify course:Early Full Remission (months 2 through 12), early Partial Remission (months 2 through 12), Sustained FullRemission (months 13+), Sustained Partial Remission (months 13+)

Specify one, either or both of:

On Agonist Therapy (does not apply to Cannabis, Hallucinogens, Inhalants, PCP)

In a Controlled Environment (does not apply to Nicotine)

Criterios generales para la clasificacin de dependencia de una sustancia


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Criterios generales para la clasificacin de retiro de una sustancia

A syndrome specific to a substance develops when someone who has used

it frequently and for a long time suddenly stops or markedly reduces its

intake.

This syndrome causes clinically important distress or impairs work, social

or personal functioning.

This syndrome is neither the result of a general medical condition nor

better explained by a different mental disorder.


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Remission

No patient can be said to be in any sort of remission until there have been no symptoms of

either dependence or abuse for one month or more. [Note that the criteria for remission include

all the symptoms of both dependence and abuse.]

To add any course modifier for substance dependence, the patient must have: for at least one

month, no use of the substance and no problems from its use. A person who has stopped using

but is still trying to get a drug, for example, would not qualify for any type of remission.

All remissions can be divided in two ways: into full versus partial and early versus sustained.

Early remission. This period comprises months 2-12 after the patient last experienced problems

with the substance. This period of time was singled out because most patients are especiallyvulnerable to relapse during the first year of sobriety.

Sustained remission. After the first year, the patient is said to be in sustained remission.

During both of these time periods, a patient will be in partial or full remission:

Full remission. There have been no symptoms of dependence or of abuse. During months 2-12

this would be called early full remission; after the first year is termed sustained full remission.

Partial remission. The patient has met at least one criterion for either dependence or abuse, but

does not fully qualify for either of these diagnoses. The terms early partial and sustained partial

remission apply, as above.


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Generic Criteria for Substance Abuse

The patient's maladaptive substance use pattern causes clinically important distress

or impairment as shown in a single 12-month period by 1 or more of the following:

-Because of repeated use, the patient fails to carry out major obligations at work or athome.

-The patient uses substances even when it is physically dangerous.

-The patient repeatedly has legal problems from substance use.

-Despite knowing that it has caused or worsened social or interpersonal problems,

the patient continues to use the substance.

For this class of substance, the patient has never fulfilled criteria for Substance

Dependence.

Substance Intoxication

The patient develops a reversible syndrome due to recent use of or exposure to a

substance.During or shortly after using the substance, the patient develops clinically important

behavioral or psychological changes that are maladaptive.

This condition is neither the result of a general medical condition nor better

explained by a different mental disorder.


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Alcohol Withdrawal

A patient who has been drinking heavily and for a long time suddenly stops or

markedly reduces its intake.

Within a few hours to several days of reducing intake, 2 or more of the following

develop:

-autonomic overactivity (sweating or rapid heartbeat)

-worsened tremor of hands

-insomnia

-nausea or vomiting

-short-lived hallucinations or illusions (visual, tactile or auditory)

-psychomotor agitation

-anxiety

-grand mal seizures

These symptoms cause clinically important distress or impair work, social orpersonal functioning.

These symptoms are neither the result of a general medical condition nor better

explained by a different mental disorder.

Specify if: With Perceptual Disturbances. The patient has altered perceptions:

auditory, tactile or visual illusions or hallucinations with intact insight.*


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Alcohol Intoxication

The patient has recently drunk alcohol.

During or shortly after drinking, the patient develops clinically importantbehavioral or psychological changes that are maladaptive. These could

include inappropriate sexuality or aggression, lability of mood, impaired

judgment and impaired job or social functioning.

Shortly after drinking, 1 or more of:

-slurred speech-poor coordination

-unsteady walking

-nystagmus

-impaired attention or memory

-stupor or coma These symptoms are neither the result of a general medical condition nor

better explained by a different mental disorder.


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Amphetamine Intoxication

The patient has recently used amphetamine or a related substance.

During or shortly after its use, the patient develops clinically importantbehavioral or psychological changes that are maladaptive. These could include

blunted affect, hypervigilance, interpersonal sensitivity, anger, anxiety ortension, changes in sociability, stereotyped behaviors, impaired judgment andimpaired job or social functioning.

Shortly after use, 2 or more of:-slowed or rapid heart rate-dilated pupils

-raised or lowered blood pressure-chills or sweating-nausea or vomiting-weight loss-psychomotor agitation or retardation-muscle weakness, shallow or slowed breathing, chest pain or heartarrhythmias

-coma, confusion, dyskinesias, dystonias or seizures

These symptoms are neither the result of a general medical condition norbetter explained by a different mental disorder.

Specify if: With Perceptual Disturbances. The patient has altered perceptions:auditory, tactile or visual illusions or hallucinations with intact insight.*


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Amphetamine Withdrawal

A patient who has been using an amphetamine or a similar substance

heavily and for a long time suddenly stops or markedly reduces itsintake.

Within a few hours to several days of reducing intake, the patientdevelops dysphoric mood and 2 or more of the following:-fatigue-unpleasant, vivid dreams-hypersomnia or insomnia-increased appetite-psychomotor agitation or retardation

These symptoms cause clinically important distress or impaired work,social or personal functioning.

These symptoms are neither the result of a general medical conditionnor better explained by a different mental disorder.


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Caffeine Intoxication

The patient has recently consumed caffeine (usually, more than 250 mg, or 2-3cups of coffee).

Beginning during or shortly after ingestion, 5 or more of:-restlessness-nervousness-excitement-insomnia-red face-increased urination-gastrointestinal upset-muscle twitching-rambling speech-rapid or irregular heart beat-periods of tirelessness-psychomotor agitation

These symptoms cause clinically important distress or impair work , social orpersonal functioning.



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Cannabis Intoxication

The patient has recently used cannabis.

During or shortly after its use, the patient develops clinically important

behavioral or psychological changes that are maladaptive. These could

include anxiety, euphoria, impaired judgment, social withdrawal and

the sensation that time has slowed down.

Within 2 hours of use, 2 or more of:

-red eyes

-increased appetite

-dry mouth

-rapid heart rate

These symptoms are neither the result of a general medical condition

nor better explained by a different mental disorder.

Specify if: With Perceptual Disturbances. The patient has altered

perceptions: auditory, tactile or visual illusions or hallucinations with

intact insight.*


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Hallucinogen Intoxication

The patient has recently used a hallucinogen.

During or shortly after its use, the patient develops clinically important

behavioral or psychological changes that are maladaptive. These couldinclude severe depression or anxiety, ideas of reference, fear of

becoming insane, persecutory ideas, impaired judgment and impairedjob or social functioning.

During or shortly after use, while fully alert the patient has perceptualchanges (depersonalization, derealization, illusions, hallucinations,

synesthesias or subjective intensification of experience). Shortly after use, 2 or more of:

-dilated pupils-rapid heart rate-sweating

-irregular heartbeat-blurred vision-tremors-incoordination

These symptoms are neither the direct result of a general medicalcondition nor better explained by a different mental disorder.


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Hallucinogen Persisting Perception Disorder (Flashbacks).

After stopping the use of a hallucinogen, the patient

reexperiences at least one of the symptoms of perception that

occurred during intoxication. These could include flashes of

color, trails of images, afterimages, halos, macropsia, micropsia,

geometric hallucinations and false peripheral perception of

movement. These symptoms cause clinically important distress or impair

work, social or personal functioning.

These symptoms are neither the result of a general medical

condition nor better explained by hypnopompic hallucinations

or a different mental disorder such as Schizophrenia or

dementia.


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Inhalant Intoxication

Recently the patient has intentionally used volatile inhalants or has had brief, high-dose exposure to them.

During or shortly after this experience, the patient develops clinically importantbehavioral or psychological changes that are maladaptive. These could includeapathy, assaultiveness or belligerence, impaired judgment and impaired job or socialfunctioning.

During or shortly after this experience, 2 or more of:-dizziness-nystagmus

-incoordination-slurred speech-unsteady walking-lethargy-diminished reflexes-psychomotor retardation

-blurred or double vision-tremors-generalized muscle weakness-stupor or coma-euphoria

These symptoms are neither the result of a general medical condition nor betterexplained by a different mental disorder.


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Opioid Intoxication

The patient has recently used an opioid.

During or shortly after its use, the patient develops clinically importantbehavioral or psychological changes that are maladaptive. These couldinclude euphoria leading to apathy, depression or anxiety,

psychomotor agitation or retardation, impaired judgment and impairedjob or social functioning.

During or shortly after use, the patient develops constricted pupils (or

dilation due to brain damage following a severe overdose) and 1 ormore of:-drowsiness or coma-slurred speech-impaired memory or attention

These symptoms are neither the result of a general medical condition

nor better explained by a different mental disorder.Specify if: With Perceptual Disturbances. The patient has altered

perceptions: auditory, tactile or visual illusions or hallucinations withintact insight.*


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Opioid Withdrawal

The patient has either:-Recently stopped or reduced use of opioids after heavy, prolonged use

(at least several weeks) or-Been given an opioid antagonist after using opioids for some time

Within minutes to several days after this experience, the patientdevelops 3 or more of:-dysphoria-nausea or vomiting

-aching muscles-tearing or runny nose-dilated pupils, piloerection or sweating-diarrhea-yawning-fever

-insomnia These symptoms cause clinically important distress or impair work,

social or personal functioning.

These symptoms are neither the result of a general medical conditionnor better explained by a different mental disorder.


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Phencyclidine (or Related Substance) Intoxication

The patient has recently used PCP or a related substance.

During or shortly after its use, the patient develops clinically importantbehavioral or psychological changes that are maladaptive. These would

include assault, belligerence, impulsivity, agitation, unpredictability, impairedjudgment and impaired job or social functioning.

Within an hour of use (less, if snorted, smoked or used IV), the patientdevelops 2 or more of:-nystagmus-rapid heartbeat or high blood pressure

-numbness or decreased response to pain-trouble walking-trouble speaking-rigid muscles-coma or seizures-abnormally acute hearing


Specify if: With Perceptual Disturbances. The patient has altered perceptions:auditory, tactile or visual illusions or hallucinations with intact insight.*


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Sedative, Hypnotic or Anxiolytic Intoxication

The patient has recently used a sedative, hypnotic or anxiolyticdrug.

During or shortly after use, the patient develops clinicallyimportant behavioral or psychological changes that aremaladaptive. These would include inappropriate sexuality oraggression, lability of mood, impaired judgment and impaired jobor social functioning.

Shortly after use, 1 or more of:-slurred speech-incoordination-unsteady walking-nystagmus-impaired attention or memory

-stupor or coma

These symptoms are neither the result of a general medicalcondition nor better explained by a different mental disorder.


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trastornos inducidos por sustancias - criterios del dsm iv

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