گفتار درمانی تخصصی سه راه گوهردشت سیاوش عطائی کرج 09121623463 Sedative, Hypnotic, or Anxiolytic Use Disorder

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Diagnostic Criteria [1] [2]

  1. Recurrent sedative, hypnotic, or anxiolytic use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by sedative, hypnotic, or anxiolytic use).
  2. Sedative, hypnotic, or anxiolytic use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the sedative, hypnotic, or anxiolytic.
  3. Tolerance, as defined by either of the following:
  4. A need for markedly increased amounts of the sedative, hypnotic, or anxiolytic to achieve intoxication or desired effect.
  5. A markedly diminished effect with continued use of the same amount of the sed­ative, hypnotic, or anxiolytic.

Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.

  1. Withdrawal, as manifested by either of the following:
  2. The characteristic withdrawal syndrome for sedatives, hypnotics, or anxiolytics (refer to Criteria A and B of the criteria set for sedative, hypnotic, or anxiolytic withdrawal, pp. 557-558).
  3. Sedatives, hypnotics, or anxiolytics (or a closely related substance, such as al­cohol) are taken to relieve or avoid withdrawal symptoms.

Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.

Specify if:

In early remission: After full criteria for sedative, hypnotic, or anxiolytic use disorder were previously met, none of the criteria for sedative, hypnotic, or anxiolytic use disor­der have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the sedative, hypnotic, or anxiolytic,” may be met).

In sustained remission: After full criteria for sedative, hypnotic, or anxiolytic use dis­order were previously met, none of the criteria for sedative, hypnotic, or anxiolytic use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the sedative, hypnotic, or anxiolytic,” may be met).

Specify it:

In a controlled environment: This additional specifier is used if the individual is in an environment where access to sedatives, hypnotics, or anxiolytics is restricted.

Coding based on current severity: Note for ICD-10-CM codes: If a sedative, hypnotic, or anxiolytic intoxication; sedative, hypnotic, or anxiolytic withdrawal; or another sedative-, hypnotic-, or anxiolytic-induced mental disorder is also present, do not use the codes be­low for sedative, hypnotic, or anxiolytic use disorder. Instead the comorbid sedative, hyp­notic, or anxiolytic use disorder is indicated in the 4th character of the sedative-, hypnotic-, or anxiolytic-induced disorder (see the coding note for sedative, hypnotic, or anxiolytic in­toxication; sedative, hypnotic, or anxiolytic withdrawal; or specific sedative-, hypnotic-, or anxiolytic-induced mental disorder). For example, if there is comorbid sedative-, hypnotic-, or anxiolytic-induced depressive disorder and sedative, hypnotic, or anxiolytic use disor­der, only the sedative-, hypnotic-, or anxiolytic-induced depressive disorder code is given with the 4th character indicating whether the comorbid sedative, hypnotic, or anxiolytic use disorder is mild, moderate, or severe: F13.14 for mild sedative, hypnotic, or anxiolytic use disorder with sedative-, hypnotic-, or anxiolytic-induced depressive disorder or F13.24 for a moderate or severe sedative, hypnotic, or anxiolytic use disorder with sedative-, hypnotic-, or anxiolytic-induced depressive disorder.

Specify current severity:

305.40 (F13.10) Mild: Presence of 2-3 symptoms.

  • (F13.20) Moderate: Presence of 4-5 symptoms.
  • (F13.20) Severe: Presence of 6 or more symptoms.
  1. A problematic pattern of sedative, hypnotic, or anxiolytic use leading to clinically signif­icant impairment or distress, as manifested by at least two of the following, occurring

within a 12-month period:

[2]    Sedatives, hypnotics, or anxiolytics are often taken in larger amounts or over a lon­ger period than was intended.

  1. There is a persistent desire or unsuccessful efforts to cut down or control sedative, hypnotic, or anxiolytic use.
  2. A great deal of time is spent in activities necessary to obtain the sedative, hypnotic, or anxiolytic; use the sedative, hypnotic, or anxiolytic; or recover from its effects.
  3. Craving, or a strong desire or urge to use the sedative, hypnotic, or anxiolylic.
  4. Recurrent sedative, hypnotic, or anxiolytic use resulting in a failure to fulfill major role obligations at work, school, or home {e.g., repeated absences from work or poor work performance related to sedative, hypnotic, or anxiolytic use; sedative-, hypnotic-, or anxiolytic-related absences, suspensions, or expulsions from school; neglect of children or household).
  5. Continued sedative, hypnotic, or anxiolytic use despite having persistent or re­current social or interpersonal problems caused or exacerbated by the effects of sedatives, hypnotics, or anxiolytics (e.g., arguments with a spouse about conse­quences of intoxication; physical fights).
  6. Important social, occupational, or recreational activities are given up or reduced be­cause of sedative, hypnotic, or anxiolytic use.

گفتار درمانی تخصصی سه راه گوهردشت سیاوش عطائی کرج 09121623463 292.9 (F11.99) Sedative-, Hypnotic-, or Anxiolytic-Related Disorders

  • Sedative, Hypnotic, or Anxiolytic Use Disorder
    Sedative, Hypnotic, or Anxiolytic Intoxication
    Sedative, Hypnotic, or Anxiolytic Withdrawal
    Other Sedative-, Hypnotic-, or Anxiolytic-Induced Disorders
    Unspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder

گفتار درمانی تخصصی سه راه گوهردشت سیاوش عطائی کرج 09121623463 Unspecified Opioid-Related Disorder

This category applies to presentations in which symptoms characteristic of an opioid- related disorder that cause clinically significant distress or impairment in social, occupa­tional, or other important areas of functioning predominate but do not meet the full criteria for any specific opioid-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.

گفتار درمانی تخصصی سه راه گوهردشت سیاوش عطائی کرج 09121623463 Other Opioid-Induced Disorders

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The following opioid-induced disorders are described in other chapters of the manual with disorders with which they share phenomenology {see the substance/medication-induced mental disorders in these chapters): opioid-induced depressive disorder (“Depressive Dis­orders”); opioid-induced anxiety disorder (“Anxiety Disorders”); opioid-induced sleep disorder (“Sleep-Wake Disorders”); and opioid-induced sexual dysfunction (“Sexual Dys­functions”). For opioid intoxication delirium and opioid withdrawal delirium, see the crite­ria and discussion of delirium in the chapter “Neurocognitive Disorders.” These opioid- induced disorders are diagnosed instead of opioid intoxication or opioid withdrawal only when the symptoms are sufficiently severe to warrant independent clinical attention.

 

گفتار درمانی تخصصی سه راه گوهردشت سیاوش عطائی کرج 09121623463 Differential Diagnosis

Other withdrawal disorders. The anxiety and restlessness associated with opioid with­drawal resemble symptoms seen in sedative-hypnotic withdrawal. However, opioid with­drawal is also accompanied by rhinorrhea, lacrimation, and pupillary dilation, which are not seen in sedative-type withdrawal.

Other substance intoxication. Dilated pupils are also seen in hallucinogen intoxication and stimulant intoxication. However, other signs or symptoms of opioid withdrawal, such as nausea, vomiting, diarrhea, abdominal cramps, rhinorrhea, and lacrimation, are not present.

Other opioid-induced disorders. Opioid withdrawal is distinguished from the other opioid-induced disorders (e.g., opioid-induced depressive disorder, with onset during withdrawal) because the symptoms in these latter disorders are in excess of those usually associated with opioid withdrawal and meet full criteria for the relevant disorder.

کلینیک توانبخشی سیاوش عطایی:: 09121623463