The essential
features of substance-induced anxiety disorder are prominent and
persistent feelings of anxiety that are judged to be due to the
direct physiological effects of intoxication or withdrawal from
a substance. Prominent anxiety, Panic Attacks, or obsessions or
compulsions predominate in the clinical picture.
There is
evidence from the history, physical examination, or laboratory
findings of either:
The symptoms developed during, or within 1 month of, Substance
Intoxication or Withdrawal.
The symptoms persist for a substantial period of time (e.g., about
a month) after the cessation of acute withdrawal or severe intoxication
or are substantially in excess of what would be expected given
the type or amount of the substance used or the duration of use.
Medication
use is etiologically related to the disturbance.
There is other evidence suggesting the existence of an independent
non-substance-induced Anxiety Disorder (e.g., a history of recurrent
non-substance-related episodes).
The disturbance does not occur exclusively during the course of
a Delirium.
The disturbance causes clinically significant distress or impairment
in social, occupational, or other important areas of functioning.
The disturbance is not due to the direct physiological effects
of a substance (e.g., a drug of abuse, a medication) or a general
medical condition.
With Generalized
Anxiety: if excessive anxiety or worry about a number of events
or activities predominates in the clinical presentation.
With Panic Attacks: if Panic Attacks predominate in the clinical
presentation.
With Obsessive-Compulsive Symptoms: if obsessions or compulsions
predominate in the clinical presentation.
With Phobic Symptoms: if phobic symptoms predominate in the clinical
presentation.
Specify if:
With Onset During Intoxication: if the criteria are met for Intoxication
with the substance and the symptoms develop during the intoxication
syndrome.
With Onset During Withdrawal: if criteria are met for Withdrawal
from the substance and the symptoms develop during, or shortly
after, a withdrawal syndrome.
Alcohol
Because alcohol has depressive properties, acute intoxication
rarely involves acute anxiety or panic. However, acute alcohol
withdrawal, may induce an anxiety disorder. Various degrees of
subclinical anxiety ranging from panic to generalized anxiety
can last for 3-12 months after cessation of drinking.
Cocaine
& Psychostimulants
Cocaine & other psychostimulants may produce manifestations
of anxiety, most commonly during the intoxication state.
Opiates
Opiate withdrawal actually may share neurochemical characteristics
with panic disorder. also protracted anxiety during methadone
withdrawal may last several weeks or months.
Cannabis
Marijuana-induced anxiety usually occurs at high doses.
Phencyclidine
& Other Hallucinogens
PCP & hallucinogens may acutely produce anxiety & panic,
depending on the individual, dose & setting.
Miscellaneous
More commonly used drugs such as caffeine & nicotine withdrawal,
may also produce anxiety symptoms.
Associated
Features:
Substance-induced
anxiety disorder may be experienced by individuals with no preexisting
psychopathology as well as those who have a history of erratic
or maladaptive behavior. On the other hand, these episodes usually
occur in individuals with preexisting anxiety about drug use,
especially novice users or in experienced users who have taken
more than their usual dose.
Differential
Diagnosis
Some disorders
have similar symptoms. The clinician, therefore, in his diagnostic
attempt has to differentiate against the following disorders which
need to be ruled out to establish a precise diagnosis.
To Be Identified.
Cause:
Due to the
direct physiological effects of intoxication or withdrawal from
a substance.
Treatment:
Cessation
of the particular substance.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Drug counselling
may also form part of the treatment regime.
