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Lithium in opiate abuse: A theoretical approach

1979; Elsevier BV; Volume: 20; Issue: 1 Linguagem: Inglês

10.1016/0010-440x(79)90063-4

1532-8384

Abraham Flemenbaum, Alvin J. Cronson, Richard L. Weddige,

Attention Deficit Hyperactivity Disorder

K RAEPELIN REPORTED that the greatest number of first attacks of manic depressive illness occur in patients between their 15th and 20th year.’ The incidence of suicides has been increasing in this age group and, as we will see later in this review, young drug addicts account for a large percentage of these suicides. During adolescence, the presenting symptoms are not the classic ones of affective disorders and usually are not carefully scrutinized. Gallemore and Wilson” reported that many adolescent admissions were characterized by severe disorders of mood and disturbed thought as well as behavior consonant with the affect. Nevertheless, these adolescents were brought for treatment because of complaints that differed from those of typical affective disorders of later life. They were usually seen because of apathy in school and family life, wanderlust, philosophizing, temper outbursts. promiscuity, etc., so that the diagnosis was missed. They also reported a significant number of individuals in a large population of adults with affective disorders who described similar episodes of illness in their adolescent or young adult years. Despite the generally favorable outcome of the affective illness in the adolescent, the patient’s future is at stake. including the selection of a mate, education. a career. and, in general, the orderly progression of life goals. Thus, if the primary disorder goes untreated, the end result could be a drastic change in lifestyle with catastrophic outcomes including chemical dependence, antisocial acts, etc.. that will further complicate the problem of diagnosis. Drug abuse and other behaviors such as drunken driving. delinquency. antisocial acts, promiscuity, wanderlust, etc., can be parapsychiatric disorder%. as reviewed by Maze? in nonpsychiatric subjects. These parapsychiatric problems are more common in males whereas females have a higher proportion of psychiatrically-treated symptoms. However. the total number of patients with parapsychiatric problems and those with psychiatrically-treated symptoms is about the same for both sexes. Affective disorders and chemical dependence frequently overlap, but they al-e still considered to be two separate disorders. The differential diagnosis between the two conditions is frequently difficult and even the occurrence of periodicity in both conditions further complicates the problem. There is increased evidence for differentiating affective disordered alcoholics (ADA) from the ones without a significant affective component. or primary alcoholics (PA).$ However. because of the differential “presenting symptoms” in adolescents