Download - 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
y ACUTE INTOXICATION
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
y ACUTE INTOXICATION
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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THANK YOU