Addiction commonly involves a substance:
impulse disorders and obsessive-compulsive disorder (OCD), in which a person loses voluntary control over specific activities. It is thus important to consider these disorders in a differential diagnosis.
Disordered substance use is associated with increasing amounts of time spent in obtaining, taking, and recovering from the substance at the expense of time otherwise spent in other activities; unsuccessful efforts to decrease the substance use; and continuation despite recognizing its harmful effects. For many substances of abuse, genetic susceptibility is likely.
Studies support an increased association of addiction disorders among patients with comorbid schizophrenia, bipolar disorder, depression, and personality disorders (particularly antisocial and borderline personality disorders). The course is variable and dependent on many factors including the particular substance of abuse. Patients with comorbid psychiatric diagnoses ("dual diagnoses") often have more prolonged courses, perhaps due to inadequate diagnosis and treatment of the comorbidity.
Patients with these disorders may have an increased risk of various general medical conditions.
F10.20 – Alcohol dependence, uncomplicated
F11.20 – Opioid dependence, uncomplicated
F12.20 – Cannabis dependence, uncomplicated
F13.20 – Sedative, hypnotic or anxiolytic dependence, uncomplicated
F14.20 – Cocaine dependence, uncomplicated
F16.20 – Hallucinogen dependence, uncomplicated
32709003 – Addiction
Differential Diagnosis & Pitfalls
- – May be comorbid with substance use disorders or excessive behavior patterns (sex, shopping, etc); may be associated with a manic episode.
- – Excessive behaviors may be a symptom.
- – Excessive and repetitive behaviors may be a symptom.
- Neurocognitive disorders – New behaviors or changes in behaviors may be a symptom.
- Polysubstance use disorder – Keep in mind that patients may be using multiple substances.
- Medications – May cause changes in behaviors (eg, dopaminergic medications for Parkinson disease).