Each alcohol—induced mental disorder is listed in the relevant diagnostic section and there- fore only a brief description is offered here. Alcohol-induced disorders must have developed in the context of severe intoxication and / or withdrawal from the substance capable of produc- ing the mental disorder. In addition, there must be evidence that the disorder being observed is not likely to be better explained by another non-alcohol-induced mental disorder. The latter is likely to occur if the mental disorder was present before the severe intoxication or with- drawal, or continued more than 1 month after the cessation of severe intoxication and / or with- drawal. When symptoms are observed only during a delirium, they should be considered part of the delirium and not diagnosed separately, as many symptoms (including disturbances in mood, anxiety, and reality testing) are commonly seen during agitated, confused states. The a1- cohol-induced disorder must be clinically relevant, causing significant levels of distress or sig- nificant functional impairment. Finally, there are indications that the intake of substances of abuse in the context of a preexisting mental disorder are likely to result in an intensification of the preexisting independent syndrome.
The features associated with each relevant major mental disorder (e.g., psychotic epi- sodes, major depressive disorder) are similar whether observed with an independent or an alcohol-induced condition. However, individuals with alcohol-induced disorders are likely to also demonstrate the associated features seen with an alcohol use disorder, as listed in the subsections of this chapter.
Rates of alcohol-induced disorders vary somewhat by diagnostic category. For exam- ple, the lifetime risk for major depressive episodes in individuals with alcohol use disorder is approximately 40%, but only about one-third to one-half of these represent independent major depressive syndromes observed outside the context of intoxication. Similar rates of alcohol-induced sleep and anxiety conditions are likely, but alcohol-induced psychotic ep— isodes are fairly rare.
Once present, the symptoms of an alcohol-induced condition are likely to remain clinically relevant as long as the individual continues to experience severe intoxication and / or with- drawal. While the symptoms are identical to those of independent mental disorders (e.g., psychoses, major depressive disorder), and while they can have the same severe conse- quences (e.g., suicide attempts), all alcohol-induced syndromes other than alcohol- induced neurocognitive disorder, amnestic confabulatory type (alcohol-induced persist- ing amnestic disorder), regardless of the severity of the symptoms, are likely to improve relatively quickly and unlikely to remain clinically relevant for more than 1 month after cessation of severe intoxication and/ or withdrawal.
The alcohol-induced disorders are an important part of the differential diagnoses for the independent mental conditions. Independent schizophrenia, major depressive disor- der, bipolar disorder, and anxiety disorders, such as panic disorder, are likely to be asso- ciated with much longer-lasting periods of symptoms and often require longer-term medications to optimize the probability of improvement or recovery. The alcohol-induced conditions, on the other hand, are likely to be much shorter in duration and disappear within several days to 1 month after cessation of severe intoxication and / or withdrawal, even without psychotropic medications.
The importance of recognizing an alcohol-induced disorder is similar to the relevance of identifying the possible role of some endocrine conditions and medication reactions be- fore diagnosing an independent mental disorder. In light of the high prevalence of alcohol use disorders worldwide, it is important that these alcohol-induced diagnoses be consid- ered before independent mental disorders are diagnosed.
291.9 (F10.99)
This category applies to presentations in which symptoms characteristic of an alcohol- related disorder that cause clinically significant distress or impairment in social, occupa- tional, or other important areas of functioning predominate but do not meet the full criteria for any specific alcohoI-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.