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
Trastornos relacionados con
alucingenos

1. Trastornos por consumo de
alucingenos:
Dependencia de alucingenos
Abuso de alucingenos
2. Trastornos inducidos por
alucingenos
Intoxicacin
Trastorno perceptivo persistente
Delirium
Trastorno psictico
Trastorno de ansiedad
Trastorno del estado de nimo
Trastornos relacionados con
anfetaminas (o sustancias de accin
similar)

1. Trastornos por consumo de
anfetaminas
Dependencia de anfetaminas
Abuso de anfetaminas
2. Trastornos inducidos por
anfetaminas
Intoxicacin
Abstinencia
Delirium
Trastorno psictico
Trastorno de ansiedad
Trastorno del sueo
Trastorno sexual
Trastorno del estado de nimo
Trastornos relacionados con cafena

1. Trastornos inducidos por cafena
Intoxicacin
Trastorno de ansiedad
Trastorno del sueo
Trastorno relacionado con cafena no
especificado

Trastornos relacionados con cannabis

1. Trastornos por consumo de cannabis
Dependencia de cannabis
Abuso de cannabis

2. Trastornos inducidos por cannabis
Intoxicacin
Delirium
Trastorno psictico
Trastornos de ansiedad
Trastorno relacionado con cannabis no
especificado
Trastornos relacionados con cocana

1. Trastornos por consumo de cocana
Dependencia de cocana
Abuso de cocana

2. Trastornos inducidos por cocana
Intoxicacin
Abstinencia
Delirium
Trastorno psictico
Trastorno del estado de nimo
Trastorno de ansiedad
Trastorno del sueo
Trastorno sexual
Trastorno relacionado con cocana no
especificado

Trastornos relacionados con fenciclidina

1. Trastornos por consumo de fenciclidina
Dependencia de fenciclidina
Abuso 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 inhalantes
2. Abuso de inhalantes
3. 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 de
nicotina
2. Trastornos inducidos por nicotina:
abstinencia
trastorno relacionado con nicotina no especificado

Trastornos relacionados con opiceos

1. Trastornos por consumo de opiceos
Dependencia de opiceos
Abuso 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.



Trastornos relacionados con sedantes, hipnticos
o ansiolticos

1. Trastorno por consumo de sedantes, hipnticos
o ansiolticos
Dependencia de sedantes,
hipnticos o ansiolticos
Abuso de sedantes, hipnticos o ansiolticos

2. Trastornos inducidos por sedantes, hipnticos
o 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 o
ansiolticos no especificado

Trastornos relacionados con varias sustancias

1. Dependencia de varias sustancias

Trastornos relacionados con otras sustancias (o
desconocidas)

1. Trastorno por consumo de otras sustancias (o
desconocidas)
Dependencia de otras sustancias
Abuso de otras sustancias

2. Trastornos inducidos por otras sustancias (o
desconocidas):
intoxicacin,
abstinencia,
delirium,
demencia,
trastorno amnsico,
trastorno del estado de nimo,
trastorno sexual y
trastorno relacionado con otras sustancias (o
desconocidas) no especificado

The patient's maladaptive pattern of substance use leads to clinically important distress or
impairment 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 of
substance use.
-The patient continues to use the substance, despite knowing that it has probably caused physical or
psychological 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 Full
Remission (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
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.

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 especially
vulnerable 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.
On Agonist Therapy
This term describes patients who (1) have previously met criteria for
dependence, (2) have not met criteria for dependence or abuse for at least
one month and (3) are currently taking medication to block the effects of the
substance in question. Examples: An alcohol-dependent patient takes
disulfiram (Antabuse); a heroin-dependent patient takes methadone.

In A Controlled Environment
Patients who are in remission but live in an environment where it would be
very difficult to obtain the substance may merit the modifier "in a controlled
environment." Such an environment would include a therapeutic community
or a jail or locked hospital ward with good control of contraband. This term
would not be applied during the first month.


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 at
home.
-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.
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 or
personal 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.*
Alcohol Intoxication
The patient has recently drunk alcohol.
During or shortly after drinking, the patient develops clinically important
behavioral 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.


Amphetamine Intoxication
The patient has recently used amphetamine or a related substance.
During or shortly after its use, the patient develops clinically important
behavioral or psychological changes that are maladaptive. These could include
blunted affect, hypervigilance, interpersonal sensitivity, anger, anxiety or
tension, changes in sociability, stereotyped behaviors, impaired judgment and
impaired 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 heart
arrhythmias
-coma, confusion, dyskinesias, dystonias or seizures
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.*
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 its
intake.
Within a few hours to several days of reducing intake, the patient
develops 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 condition
nor better explained by a different mental disorder.

Caffeine Intoxication
The patient has recently consumed caffeine (usually, more than 250 mg, or 2-3
cups 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 or
personal functioning.
These symptoms are neither the result of a general medical condition nor
better explained by a different mental disorder.

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.*

Cocaine Intoxication
The patient has recently used cocaine.
During or shortly after its use, the patient develops clinically important
behavioral or psychological changes that are maladaptive. These would
include blunted affect, hypervigilance, interpersonal sensitivity, anger,
anxiety or tension, changes in sociability, stereotyped behaviors, impaired
judgment and impaired 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 cardiac
arrhythmias
-coma, confusion, dyskinesias, dystonias or seizures
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.*
Cocaine Withdrawal
A patient who has been using cocaine heavily and for a long
time suddenly stops or markedly reduces its intake.
Within a few hours to several days of reducing intake, the
patient has 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 impair
work, social or personal functioning.
These symptoms are neither the result of a general medical
condition nor better explained by a different mental disorder.

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 could
include severe depression or anxiety, ideas of reference, fear of
becoming insane, persecutory ideas, impaired judgment and impaired
job or social functioning.
During or shortly after use, while fully alert the patient has perceptual
changes (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 medical
condition nor better explained by a different mental disorder.
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.

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 important
behavioral or psychological changes that are maladaptive. These could include
apathy, assaultiveness or belligerence, impaired judgment and impaired job or social
functioning.
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 better
explained by a different mental disorder.
Nicotine Withdrawal
The patient has used nicotine daily for several weeks or more.
Within 24 hours of abruptly reducing nicotine intake, the patient
develops 4 or more of:
-dysphoria or depression
-insomnia
-anger, frustration or irritability
-anxiety
-trouble concentrating
-restlessness
-slowed heart rate
-increased appetite or weight
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 a different mental disorder.

Opioid Intoxication
The patient has recently used an opioid.
During or shortly after its use, the patient develops clinically important
behavioral or psychological changes that are maladaptive. These could
include euphoria leading to apathy, depression or anxiety,
psychomotor agitation or retardation, impaired judgment and impaired
job 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 or
more 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 with
intact insight.*
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 patient
develops 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 condition
nor better explained by a different mental disorder.

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 important
behavioral or psychological changes that are maladaptive. These would
include assault, belligerence, impulsivity, agitation, unpredictability, impaired
judgment and impaired job or social functioning.
Within an hour of use (less, if snorted, smoked or used IV), the patient
develops 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
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.*

Sedative, Hypnotic or Anxiolytic Intoxication
The patient has recently used a sedative, hypnotic or anxiolytic
drug.
During or shortly after use, the patient develops clinically
important behavioral or psychological changes that are
maladaptive. These would include inappropriate sexuality or
aggression, lability of mood, impaired judgment and impaired job
or 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 medical
condition nor better explained by a different mental disorder.

Sedative, Hypnotic or Anxiolytic Withdrawal
A patient who has been using one or more of these drugs heavily and for a
long time suddenly markedly reduces its intake.
Within a few hours to several days, 2 or more of the following develop:
-autonomic overactivity (sweating, 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 or
personal 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.*