Mental and Behavioural Disorders

Due to Psychoactive Substances

• Substance Use in the General Population

In the last few years, a great deal of data has been collected about the use, on the part of the general population, and
especially, that of medical and psychiatric patients, of pharmaceuticals, without a medical prescrip-tion, and illicit drugs. On the part of the
latter group, there is tendency to believe that this use involves a more or less conscious attempt to diminish their physical or psychological
symptomatology.
In this sense, investigators have related the consumption of illicit drugs and psychopharmacological medication in the general
population with the presence of inadequately detected psychological suffering, and,among psychiatric patients, with certain syndromes
unresolved by their prescribed treatments. It has also been found that illicit drug use is fre-quently associated with the use of
psychopharmacological medication without a prescription (Guim ́on, 1992).

• Attitudinal Profile of Persons Who ‘Self-Medicate’

Various researchers have detected a close relationship between sub-stance abuse and certain sociodemographic factors
(including sex, age,socio-economic level), both in the general population and in psychiatric patients.
The predominance of males among those who consume alcohol, il-licit drugs and psychopharmacological medication, both in
the general population and among medical patients, is in accordance with the find-ing that women present significantly more negative
attitudes than mentowards the therapeutic use of psychopharmacological medication. The predominance of young people among the self
medicated and consumersof psychotropics is in keeping with our finding (Guim ́on, 1992) showing that young people report the least fear of
psychopharmacological medi-cation. Generally, these results could be interpreted as stemming from the higher cultural level of the younger
generations, since our data show that the subjects with higher cultural levels present less prejudices regarding the use of
psychopharmacological medication
 Effects of stimulants

• Elevated mood
• increasd energy
• increased alertness
• transient psychosis
• Decreased appetite
• Autonomic Hyperarousal :
- tachicardia
- elevated blood pressure
Bi-polar Affective Disorder
(Manic Depressive Illness)
 Causes
There is a 2.5% chance of developing BPAD type I & II during your
lifetime in Australia. The chance for combined BPAD and Cyclothymic
disorder is reported as 5.2%. No racial differences exist. Males are
more likely to develop BPAD than females.

• The causes are uncertain. There is evidence of a genetic element.

Although the disorder occurs in only one to two per cent of the
general population, ten to fifteen per cent of the nearest relatives
of people with a bipolar disorder have a mood disorder. Many
perfectly normal people have a characteristic personality type
featuring rapid mood swings from cheerfulness to depression and
back again. These mood swings relate to changes in circumstances
that may have little effect on the moods of other people. People
who develop bipolar disorder will often be of this personality type.
 Signs and symptoms
Manic episodes are feature at least 1 week of profound mood disturbance, characterized by elation,
irritability, or expansiveness (referred to as gateway criteria). At least 3 of the following symptoms must
also be present :
• Grandiosity
• Diminished need for sleep
• Excessive talking or pressured speech
• Racing thoughts or flight of ideas
• Clear evidence of distractibility
• Increased level of goal-focused activity at home, at work, or sexually
• Excessive pleasurable activities, often with painful consequences

• Symptoms of Bipolar Affective Disorder (Manic Depression)

• Most patients will first present with an episode of depression. Patients will also often have
considerable anxiety and sometimes an eating disorder (such as anorexia).
• Depressive symptoms are low mood, lack of pleasure, low energy, feelings of guilt, decreased
concentration, decreased appetite and decreased sleep. These however are symptoms that are also
present with depression or even some forms of schizophrenia, making the diagnosis of bipolar
difficult.
• About a quarter of patients will present with a manic episode. These patients will present with an
elevated mood, excessive energy, decreased sleep, fast talking, sensational ideas, and an inflated
self-esteem.