Adolscence Disorder

8/9/2019 Adolscence Disorder

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BY-

DEVRAJ SHINDE


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ySubstance abuse disorder

yConduct disorder

yEating disorderySuicide and depression

y

Hyperactivity disorder


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y Intoxication The Psychological and Physical effects of the

substance disappear when the substance is eliminated.

yWithdrawal symptoms occurs when the substance is reduced orstopped.

- Tremors, convulsions, delirium tremens.(Delerium tremens is severe form of alcohol

with

drawal)- Rapid pulse rate, sweating, high B.P,disorientation, hallucination (Visual, tactile,auditory).- Delusion, agitation, fever.


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y Tolerance repeated administration leads todecreasing effect.

y Dependence syndrome Aperson is said to have adependence syndrome if they experience the followingfeatures.

- Astrong sense of compulsion to take the

substance.

- Difficulties in refraining from using the substance,

or limiting the amount taken.


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y It refers to condition arising from the abuseof alcohol, psychoactive drugs and otherchemical such as volatile solvents.

y These disorder are classified under FI in ICD

10


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yGenetic factors

yPsychological factors

ySocial factorsyEasy availability of drugs

yPsychiatric disorders


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y Alcohol Dependence Syndrome

y Other substance abuse disorder

Opioid use disorder Cannabis use disorder

Cocaine use disorder

A

mph

etamine use disorder LSD use disorder

Barbiturate use disorder


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y Traffic accidents

y School related problems

y

Risky sexual practicesy Delinquent behavior

yJuvenile crime

y

Developmental problemsy Physical and mental consequences

y Problems in family relationships


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yOn an average day about 1.2 millionadolescence, age 12 to 17, smoked

cigarettes; 6,31,000 drank alcoh

ol InIndia

yAbout 49,000 adolescents used

inh

alants, 27,000 usesh

allucinogens(e.g. Ectacy and other drugs), 13,000used cocaine and 3,800 used heroin inIndia


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y On an average day in 2009nearly 8000 adolescence drank alcohol for firsttime4000 smoked their first cigarettesand 2,500 used pain relievers for non medicalreasons for the first time

y in India in 2008more than 76,000 youth were in Out-patient

treatment10,000 in non-hospital residential treatment1000 in hospital for in patient treatment


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Alcohol

Opioids

Cannabis

Cocaine

Amphetamine

Sedatives and hypnotics

HallucinogensInhalants

Nicotine

Other stimulants


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y Sudden changes in personality

y Loss of interest

y

Sudden decline performancey Changes in friends

y Detoriation in personal grooming habits

y

Difficulty in paying attentiony Sudden aggressive behavior

y Increased secretiveness


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y DEFINITION

ALCOHOLISM refers to the use of alcoholic beveragesto the point of causing damage to the individual,

society or both.


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y Incidence of alcohol dependence is 2%

y In India 20 to 40% of subjects aged above 15 years arecurrent users and nearly 10% of them are regular or

excessive usersy Nearly 15 to 30% patients are developed alcohol-

related problems and seeking admission in psychiatrichospitals.


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ySOCIAL

Occupational/school problemsFinancial Problems

Criminality

Accidents


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yACUTE INTOXIFICATION

yWITHDRAWAL SYNDROME

yALCOHOL INDUCED AMNESTICDISORDER

yALCOHOL INDUCED PSYCHIATRIC

DISORDER


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yFull assessment

yGoal setting

yTreatment of withdrawal from alcohola) Detoxification

b) Others

y Alcohol Deterrent Therapy


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yPsychological Treatment

Motivational interviewingGroup Therapy

Aversive conditioningCognitive Therapy

Relapse prevention technique


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y Commonly abused opioids areBrawn sugar

smack

Synthetic preparation like Pentazocine

y ACUTE INTOXICATION

Apathy

Bradycardia

Hypotension

Respiratory Depression

Subnormal Temperature

Pinpoint Pupils


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y WIYHDRAWAL SYNDROME

Watery eyes

yawingirritability

tremors

Sweating

cramps

y COMPLICATION

Parkinsonism

Peripheral neuropathy

Transverse myelitis

Complication due to intravenous use


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y TREATMENT

for overdose- narcotic antagonist

detoxificationpsychological methods like

Individual Psychotherapy

Behavior Therapy

Group Therapy

FamilyTherapy


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y Derived from hemp plant- cannabis sativa

y Derived leaves and flowering tops- ganja ormarijuana

y Resin- hashish

y

Liquid from(drink)-Bh

angAcute intoxication:-

Mild intoxication-mild impairment I conciousness.andOrientation, tachycardia sense of floating in the air,euphoria, dream- like state, flash back phenomena,

alteration in PS motor activity tremors photophobia,lacrimation, dry mouth & increased appetite

Severe intoxication-perceptual disturbances-depersonalization, derealization,synesthesias &h

allucination


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y Withdrawal symptomsFirst 72-96 hoursI

ncreased salivationHyperthermiaInsomniaDecreased appetiteLoss of weight

Insomniay ComplicationTransient psy. Disorders- ac. Anxiety, paranoid psychosis,

hysterical fugue-like state, hypomania, schizophrenia- likestate

A

motivational syndromeMemory impairmenty Treatment-supportive and symptomatic


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y Street name- crack

y Oral, intranasal by smoking or parentally


Papillary dilatation

Tachycardia

Hypertension

Sweating

Nausea


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y WITHDRAWAL SYMPTOMS

Agitation, depression, Anorexia, fatigue, Sleepiness

y COMPLICATION

Acute Anxiety Reaction, Uncontrolled CompulsiveBehavior, Seizures, Respiratory Depression

y TREATMENT

Management OfIntoxication- Amyle Nitrate

(antidote)For Withdrawal symptoms- Antidepressants andpsychotherapy


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y

Powerful CNS stimulantsy Commonly used Amphetamines Pemoline and

methylphenidate


Tachycardia, Hypertension, Cardiac Failure, Seizures,

Tremors, Hyperpyrexia, Pupillary Dilatation, PanicInsomnia, Restlessness

y Withdrawal symptoms

Depression, Apathy, Fatigue, Hypersomnia, Agitation, AndHyperplegia

y COMPLICATION

Seizures, Delirium, Arrhythmias, Aggressive Behaviorcoma


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y

Powerful Hallucinogeny First Synthesized In 1938

y It acts on 5HT levels in Brain

y INTOXICATION

Perceptual Ch

anges - 2D,Illusion , Synt

hesias

Autonomic Hyperactivity, marked anxiety, ParanoidIdeation, Impairment of Judgment

y Withdrawal Syndrome flashback

y Complication- Anxiety, Depression, Psychosis ORvisual hallucinosis

y Treatment Symptomatic Treatment withAnti-Anxiety, Antidepressant or Antipsychotic


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y CommonlyAbused Barbiturates Are

Secobarbital, Phenobarbital, Amobarbital

y INTOXICATION-

Irritability, Liability Mood, Disinhibited Behavior,Slurring Of speech, Incordination, Decresed attention,

MemoryImpairment,y COMPLICATION-

From intravenous use

y WITHDRAWAL SYMPYOMS-

Marked Restlessness, Tremors, Seizuresy TREATMENT-

Induction of vomiting, use of activated Charcoal,Symptomatic


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y Commonly used volatile solvents-Petrol, Aerosols, Thinners, Varnish Removers,Industrial Solvents

y INTOXICATION-

Euphoria, Excitement, Slurring of speech, Apathy,Impaired judgment, Neurological signs

y WITHDRAWAL SYMPTOMS-

Anxiety, Depression

y

COMPLICATION-Damage to the liver And Kidney, peripheralneuropathy, perceptual disturbance, Brain Damage

y TREATMENT- Reassurance, Diazepam ForIntoxication


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yPRIMARY PREVENTION

ySECONDARY PREVENTIONyTERTIARY PREVENTION


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y Reduction of over prescribing drug

y Identification and treatment of familymember

y Introduction of social changes which likelyto affect drinking pattern in the population

y Strengthen the individual personal and

social skilly Health education to college students and

the youth about the dangers of drug abuse


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yEarly detection and counselingyBrief intervention in primary care

yMotivational inter viewing

yAfull assessment of individualyDetoxification with benzodiazepines


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y Specific measures include

alcohol deterrent therapy ( Disulfiram/Antabuse)

y Other therapies includeAssertiveness training

Teaching coping skills

Beh

avior counselingSupportive Psychotherapy

Individual Psychotherapy


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Adolscence Disorder

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