Affective symptoms include extreme reactivity of mood, feelings of chronic emptiness, and inappropriate or intense anger. Impulsive symptoms include recurrent suicidal behavior, including ideation, threats, and suicide attempts, as well…
According to the 2010 National Survey on Drug Use and Health, 200,000 U.S. residents age 12 years and older endorse past-month heroin use, and 5.1 million residents endorse past-month prescription…
Pathophysiology. Opioid tolerance and withdrawal occur as neuroadaptations to chronic opioid exposure. This neurobiology is complex, involving adaptations at all levels of opioid-sensitive brain signaling, including (1) mu-opiate receptor desensitization,…
Screening for alcohol use disorders identifies individuals at risk for developing alcohol-related problems and those already meeting criteria for an alcohol use disorder. Evidence-based screening, brief intervention, referral to treatment…
Pathophysiology. Alcohol tolerance occurs with neuroadaptations to chronic alcohol exposure. Alcohol is a sedative; chronic exposure leads to compensatory changes with reduced neurotransmission at inhibitory type A gamma-aminobutyric acid (GABA)…
Many patients with schizophrenia experience symptoms that in hindsight are recognized as a prodrome before the onset of their florid psychosis. Unspecific prodromal symptoms (anxiety, depression, social withdrawal) eventually give…
The following risk factors may increase the potential negative health consequences of drinking even with “low-risk” patterns of consumption: (1) first-degree relative with alcohol or drug dependence (i.e., heritable risk…
Patients currently classified as having somatization disorder present with multiple physical symptoms that range from mild and self-limited to severely disabling. In addition, they express excessive health concerns that are…
Diagnosis requires appropriate neurologic assessment and testing that finds the physical symptoms to be incompatible with neurologic pathophysiology and/or internally inconsistent to fulfill the first criteria. Criteria two and three…
PTSD is distinct from other common mental disorders in that trauma exposure is a prerequisite for diagnosis. Threatening events initiate the body’s “fight-or-flight” response via the hypothalamic-pituitary-adrenal axis and the…
