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Substance-Induced Psychotic Disorder
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Substance-Induced Psychotic Disorder (SIPD) displays psychotic symptoms (hallucinations not recognized by the individual as substance-induced, or delusions). In order to justify this diagnosis if they, the psychotic symptoms, must occur within a month after substance intoxication or withdrawal, or as a result of medication that caused the symptoms. However, the diagnosis is not made if the symptoms occurred before the substance or medication was ingested, or are more severe than could be reasonably caused by the amount of substance involved. If the disorder persists for more than a month after the withdrawal of the substance, the diagnosis becomes increasingly questionable, and a diagnosis of Schizophrenia, or the existence of a medical condition, becomes more plausible. Many medications and drugs of abuse, including alcohol, can cause psychotic symptoms upon intoxication and/or withdrawal. Characteristic symptoms included:

Two (or more) Criterion A ( active phase ) symptoms of the following, each present for a significant portion of time during a 1-month period:

Delusions.
Hallucinations.
Disorganized Speech (e.g., frequent derailment or incoherence).
Grossly disorganized or catatonic behavior.
Negative symptoms, i.e., affective flattening, alogia, or avolition.

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset.

Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms that meet Criterion A.

If mood episodes have occurred during Criterion A symptoms, their total duration has been brief relative to the duration of the active and residual periods.

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.

If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month.

Associated Features:

May have a previous history of drug abuse..

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.

Schizoaffective Disorder.
Mood Disorder With Psychotic Features.
Major Depressive, Manic, or Mixed Episodes.
Schizophrenia.

Cause:

Substance induced.

Treatment:

Treatment involves relieving the intoxicated condition under careful medical observation to control withdrawal symptoms, or medical management of a continuing withdrawal process or, if the condition was produced by the effects of a medication, withdrawal of the medication or reduction of the dose under close medical supervision. If these treatments are not successful, the diagnosis likely changes to primary psychosis.

Counseling and Psychotherapy [ See Therapy Section ]:

Drug counseling and supportive therapy may be beneficial. Cognitive-Behavioural therapy, for treating delusions that is based on persistent gentle discussions about evidence for the belief, might help overcome the problem the person has with believing this substitution al delusion against the available evidence.

 

DSM Code

None

F19 Substance-Induced Psychotic Disorder

Disorder Sheets

National Treatment Agency
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Skipton House
80 London Road
London
SE1 6LH
Tel: +442079721999
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Recommended Book

Cognitive Therapy for Delusions, Voices and Paranoia - Click Here to View

 

Substance-Induced Psychotic Disorder

Misc Information

None

Psychotic Disorders