Substance-related disorders in adults.

Jerrold B. Leikin, MD ubstance-related disorders are conditions in which an individual uses/ buses a substance, leading to maladaptive behaviors and symptoms. In iagnostic and Statistical Manual of Mental Health Disorders, 4th dition, text revision (DSM-IV-TR), substance-related disorders are urther grouped into substance dependence and substance abuse. Subtance abuse refers to a maladaptive pattern of substance use leading to linically significant impairment or distress, manifested by at least one ymptom that interferes with life functioning within a 12-month period. iagnostic criteria for substance dependence requires at least three of the ollowing within a 12-month period: development of tolerance to the ubstance, withdrawal symptoms, persistent desire/unsuccessful attempts o stop the substance, ingestion of larger amounts of substance than was ntended, diminished life functioning, and persistent substance use in the hase of physical or psychological problems. Substance abuse and ubstance dependence are enormous societal problems. In the United tates, the lifetime prevalence of substance abuse or dependence in adults s over 15%. The cost of addictive illness in the U.S. is estimated to be ver $144 billion annually in healthcare and job loss. Substance abuse revalence is greatest among individuals 18 to 25 years of age. Substance buse is also more common in men compared to women, and in urban esidents compared to rural residents. An average of 20% of patients in eneral medical facilities and 35% in general psychiatric units present ith substance abuse disorders. Over 50% of individuals with substance-related disorders have comorid psychiatric disorders. The term “dual diagnosis” usually refers to ndividuals with concomitant substance abuse and psychiatric diagnosis. omorbid psychiatric diagnoses, common in individuals who abuse ubstances, include major depression, personality disorder, particularly ntisocial personality, anxiety disorders, and dysthymia. Genetic studies