Other Substance Use Disorders MCQs

Explanation: The patient has difficulty ejaculating during partnered sexual encounters, which has developed after the initiation of SSRI treatment, suggesting a medication-related issue. Delayed Ejaculation: Duration: Symptoms must persist for at least 6 months. Symptoms: Difficulty with ejaculations: Delayed ejaculation. Absent or reduced frequency of ejaculation. Marked delay or absence of orgasm. Symptoms Needed: At least one symptom must occur. Exclusions: Symptoms should not be attributed to: Relationship problems. Substance use (including prescribed medications). Another medical condition. Another psychiatric condition. Severity Specifiers: Mild: Causes mild distress. Moderate: Causes moderate distress. Severe: Causes severe distress.

This patient is suffering from classic symptoms of opioid withdrawal. Buprenorphine is a partial agonist which, when given to a patient actively using another opiate, will precipitate withdrawal. Alprazolam and cocaine would not present with this clinical picture.( OPTION A & C ) Methadone and morphine are opioids which would cause further intoxication, not withdrawal.( OPTION D ) Reference: Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 29, Psychopharmacological treatment, Page no. 1002.

Anandamide , an ingredient in chocolate, stimulates the same receptors as marijuana. Other compounds in chocolate include tryptophan , the precursor of serotonin and phenylalanine , an amphetamine-like substance, both of which improve mood. So-called chocoholics may be self-medicating because of a depressive diathesis. Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11 th edition, Chapter 20.12, Other Substance Use and Addictive Disorders, Page number 690.

Family history of suicide ( OPTION A ), previous suicidal attempts (OPTION B) , substance abuse , and chaotic family background are all high risk factors for suicide . Reference : Kaplan and Sadock's Synopsis of Psychiatry, 11th edition, Chapter 23.1 Suicide, Page number 763

The following substances are prone to cause Anxiety Disorder: Alcohol Caffeine Cannabis Cocaine Phencyclidine Hallucinogen(LSD) Opioid Amphetamines Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 9, Anxiety Disorders, Page no. 413.

A diagnosis of polysubstance dependence is appropriate if, for a period of at least 12 months, a person has repeatedly used substances from at least three categories, NOT including nicotine and caffeine . Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11 th edition, Chapter 20.12, Other Substance Use and Addictive Disorders, Page number 690.

Panic-inducing substances (sometimes called panicogens) induce panic attacks in most patients with panic disorder . Respiratory Panicogens: Carbon Dioxide (5-35% mixtures) Sodium lactate Sodium bicarbonate Neurochemical Panicogens (act through specific neurotransmitter systems): Yohimbine mCPP and m-caroline drugs GABA-b receptor inverse agonists: Flumazenil Cholecystokinin Caffeine Isoproterenol is also a panicogen, however, its mechanism of action is poorly understood. Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th Edition, Page Number-392.

According to DSM-V criteria, patients developing a mood disorder after using a substance(either illicit or prescribed) are diagnosed with a substance-induced mood disorder. The diagnosis of major depression cannot be made in the presence of either substance use or a general medical condition that might be the cause of the mood disorder. Prednisone is a common culprit in causing mood disorders ranging from depression to mania to psychosis. Reference: Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 8th, Mood disorders, Page no. 371.