ADOLSCENCE DISORDER

BY-
DEVRAJ SHINDE
INTRODUCTION
COMMON CAUSES FOR MENTAL
HEALTH PROBLEMS AMONG
ADOLSCENCE
ADOLSCENCE DISORDERS
Substance abuse disorder
Conduct disorder
Eating disorder
Suicide and depression
Hyperactivity disorder
SUBSTANCE ABUSE DISORDER
Some Terminology
Intoxication –
The Psychological and Physical effects of the substance
disappear when the substance is eliminated.

Withdrawal symptoms –
occurs when the substance is reduced or stopped.
- Tremors, convulsions, delirium tremens.
(Delerium tremens is severe form of alcohol
withdrawal)
- Rapid pulse rate, sweating, high B.P,
disorientation, hallucination (Visual, tactile,
auditory).
- Delusion, agitation, fever.
Tolerance – repeated administration leads to
decreasing effect.

Dependence syndrome – A person is said to have a

dependence syndrome if they experience the following
features.

- A strong sense of compulsion to take the

substance.

- Difficulties in refraining from using the substance,

or limiting the amount taken.
DIFINITION OF SUBSTANCE ABUSE
DISORDER
It refers to condition arising from the abuse
of alcohol, psychoactive drugs and other
chemical such as volatile solvents.

These disorder are classified under FI in

ICD 10
ETIOLOGICAL FACTORS IN
SUBSTANCE ABUSE
Genetic factors
Psychological factors
Social factors
Easy availability of drugs
Psychiatric disorders
Various substance abuse disorders..
Alcohol Dependence Syndrome
Other substance abuse disorder
 Opioid use disorder
 Cannabis use disorder
 Cocaine use disorder
 Amphetamine use disorder
 LSD use disorder
 Barbiturate use disorder
CONSEQUENCES OF ADOLSCENT
SUBSTANCE ABUSE
Traffic accidents
School related problems
Risky sexual practices
Delinquent behavior
Juvenile crime
Developmental problems
Physical and mental consequences
Problems in family relationships
FACTS ABOUT ADOLSCENCE
SUBSTANCE ABUSE
On an average day about 1.2 million
adolescence, age 12 to 17, smoked
cigarettes; 6,31,000 drank alcohol In
India
About 49,000 adolescents used
inhalants, 27,000 uses
hallucinogens( e.g. Ectacy and other
drugs), 13,000 used cocaine and 3,800
used heroin in India
Cont…….
On an average day in 2009
nearly 8000 adolescence drank alcohol for first time
4000 smoked their first cigarettes
and 2,500 used pain relievers for non medical reasons
for the first time
in India in 2008
more than 76,000 youth were in Out-patient treatment
10,000 in non-hospital residential treatment
1000 in hospital for in patient treatment
Drugs which are used by adolescence
Alcohol
Opioids
Cannabis
Cocaine
Amphetamine
Sedatives and hypnotics
Hallucinogens
Inhalants
Nicotine
Other stimulants
SIGNS AND SYMPTOMS OF
SUBSTANCE USE
Sudden changes in personality
Loss of interest
Sudden decline performance
Changes in friends
Detoriation in personal grooming habits
Difficulty in paying attention
Sudden aggressive behavior
Increased secretiveness
ALCOHOL DEPENDENCE
SYNRDOME
DEFINITION
ALCOHOLISM refers to the use of alcoholic beverages
to the point of causing damage to the individual,
society or both.
PROPERTIES OF ALCOHOL
EPIDEMIOLOGY
Incidence of alcohol dependence is 2%
In India 20 to 40% of subjects aged above 15 years are
current users and nearly 10% of them are regular or
excessive users
Nearly 15 to 30% patients are developed alcohol-
related problems and seeking admission in psychiatric
hospitals.
MEDICAL AND SOCIAL
COMPLICATION
MEDICAL
Gastro-intestine system
Cardiovascular system
Central nervous system
Damage to the fetus
Miscellaneous
SOCIAL
Occupational/school problems
Financial Problems
Criminality
Accidents
PSYCHIATRIC DISORDER DUE TO
ALCOHOL DEPENDANCE
ACUTE INTOXIFICATION
WITHDRAWAL SYNDROME
ALCOHOL INDUCED AMNESTIC
DISORDER
ALCOHOL INDUCED PSYCHIATRIC
DISORDER
TREATMENT
Full assessment
Goal setting
Treatment of withdrawal from alcohol
a) Detoxification
b) Others
 Alcohol Deterrent Therapy
Psychological Treatment
Motivational interviewing
Group Therapy
Aversive conditioning
Cognitive Therapy
Relapse prevention technique
OPIOID USE DISORDER
Commonly abused opioids are
Brawn sugar
smack
Synthetic preparation like Pentazocine
 ACUTE INTOXICATION
Apathy
Bradycardia
Hypotension
Respiratory Depression
Subnormal Temperature
Pinpoint Pupils
WIYHDRAWAL SYNDROME
Watery eyes
yawing
irritability
tremors
Sweating
cramps
COMPLICATION
Parkinsonism
Peripheral neuropathy
Transverse myelitis
Complication due to intravenous use
TREATMENT
for overdose- narcotic antagonist
detoxification
psychological methods like
Individual Psychotherapy
Behavior Therapy
Group Therapy
Family Therapy
CANNABIS USE DISORDER
Derived from hemp plant- cannabis sativa
Derived leaves and flowering tops- ganja or marijuana
Resin- hashish
Liquid from(drink)- Bhang
Acute intoxication:-
Mild intoxication-mild impairment I conciousness.and
Orientation, tachycardia sense of floating in the air,
euphoria, dream- like state, ‘flash back’ phenomena,
alteration in PS motor activity tremors photophobia,
lacrimation, dry mouth & increased appetite
Severe intoxication-perceptual disturbances-
depersonalization, derealization,synesthesias &
hallucination
Withdrawal symptoms
First 72-96 hours
Increased salivation
Hyperthermia
Insomnia
Decreased appetite
Loss of weight
Insomnia
Complication
Transient psy. Disorders- ac. Anxiety, paranoid psychosis,
hysterical fugue-like state, hypomania, schizophrenia- like state
Amotivational syndrome
Memory impairment
Treatment-supportive and symptomatic
COCAINE USE DISORDER
Street name- crack
Oral, intranasal by smoking or parentally
ACUTE INTOXICATION
Papillary dilatation
Tachycardia
Hypertension
Sweating
Nausea
WITHDRAWAL SYMPTOMS
Agitation, depression, Anorexia, fatigue, Sleepiness
COMPLICATION
Acute Anxiety Reaction, Uncontrolled Compulsive
Behavior, Seizures, Respiratory Depression
TREATMENT
Management Of Intoxication- Amyle Nitrate
(antidote)
For Withdrawal symptoms- Antidepressants and
psychotherapy
AMPHETAMINE USE DISORDER
Powerful CNS stimulants
Commonly used Amphetamines Pemoline and
methylphenidate
ACUTE INTOXICATION
Tachycardia, Hypertension, Cardiac Failure, Seizures,
Tremors, Hyperpyrexia, Pupillary Dilatation, Panic
Insomnia, Restlessness
Withdrawal symptoms
Depression, Apathy, Fatigue, Hypersomnia, Agitation, And
Hyperplegia
COMPLICATION
Seizures, Delirium, Arrhythmias, Aggressive Behavior coma
 LSD USE DISORDER
Powerful Hallucinogen
First Synthesized In 1938
It acts on 5HT levels in Brain
INTOXICATION
Perceptual Changes - 2D, Illusion , Synthesias
Autonomic Hyperactivity, marked anxiety, Paranoid
Ideation, Impairment of Judgment
 Withdrawal Syndrome – flashback
Complication- Anxiety, Depression, Psychosis OR visual
hallucinosis
Treatment – Symptomatic Treatment with Anti-Anxiety,
Antidepressant or Antipsychotic
 BARBITURATE USE DISORDER
Commonly Abused Barbiturates Are
Secobarbital, Phenobarbital, Amobarbital
INTOXICATION-
Irritability, Liability Mood, Disinhibited Behavior, Slurring
Of speech, Incordination, Decresed attention, Memory
Impairment,
COMPLICATION-
From intravenous use
WITHDRAWAL SYMPYOMS-
Marked Restlessness, Tremors, Seizures
TREATMENT-
Induction of vomiting, use of activated Charcoal,
Symptomatic
INHALENTS OR VOLATILE SOLVENTS
USE DISORDER
Commonly used volatile solvents-
Petrol, Aerosols, Thinners, Varnish Removers, Industrial
Solvents
INTOXICATION-
Euphoria, Excitement, Slurring of speech, Apathy,
Impaired judgment, Neurological signs
WITHDRAWAL SYMPTOMS-
Anxiety, Depression
COMPLICATION-
Damage to the liver And Kidney, peripheral neuropathy,
perceptual disturbance, Brain Damage
TREATMENT- Reassurance, Diazepam For Intoxication
PREVENTION OF SUBSTANCE
ABUSE DISORDER

PRIMARY PREVENTION
SECONDARY PREVENTION
TERTIARY PREVENTION
 PRIMARY PREVENTION
Reduction of over prescribing drug
Identification and treatment of family
member
Introduction of social changes which likely
to affect drinking pattern in the population
Strengthen the individual personal and
social skill
Health education to college students and
the youth about the dangers of drug abuse
 SECONDARY PREVENTION
Early detection and counseling
Brief intervention in primary care
Motivational inter viewing
A full assessment of individual
Detoxification with benzodiazepines
 TERTIARY PREVENTION
Specific measures include
alcohol deterrent therapy ( Disulfiram/
Antabuse)
Other therapies include
Assertiveness training
Teaching coping skills
Behavior counseling
Supportive Psychotherapy
Individual Psychotherapy
NURSING MANAGEMENT
 RESEARCH EVIDENCE
BY RESEARCH
It confirm that BIPOLAR DISORDER in
ADOLSCENTS is huge risk factor for smoking and
substance abuse, as big a risk factor as JUVENILE
DELINQUENCY.
SUMMERY AND CONCLUSION
ANY QUESTIONS

?
Ain't no power like the power of youth cos the power of youth don't stop!

THANK YOU