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Alcoholism

Author: RxPG, Posted on Wednesday, June 30 @ 00:00:00 IST by RxPG  

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Psychiatry

QUESTION.
A 20- year-old man has presented with increased alcohol consumption and sexual indulgence, irritability, lack of sleep, and not feeling fatigued even on prolonged periods of activity. All these changes have been present for 3 weeks. The most likely diagnosis is:

1. Alcohol dependence.
2. Schizophrenia.
3. Mania.
4. Impulsive control disorder.



Answer
3. Mania.

Reference
A Short Textbook of Psychiatry by Ahuja 4 ed Page 65

Quality
Reader

Status
Repeat

QTDF
Ahuja

Discussion
Features of Manic Episodes (at least for 1 week) include
1. Elevated, Expansive or Irritable Mood

Stages Mood
Euphoria Mild Elevation of Mood Psychological Well being Hypomania Stage I
Elation Moderate Elevation of Mood Increased psychomotor activity Classical Mania Stage II
Exaltation Severe Elevation of Mood Intense Elation with Delusion of Grandeur Severe Mania Stage III
Ecstasy Very Severe Elevation of Mood Intense sense of Rapture Delirious or Stuporous Mania Stage IV

2. Psychomotor Activity
a. Overactiveness and Restlessness
b. Activity is Goal Oriented
c. Patient is “on the go”
3. Speech and thought
a. More talkative, Describes thoughts racing in Mind, develops pressure of speech, uses playful language with puning, rhyming, joking and teasing
b. Flight of Ideas
4. Goal – directed Activity
a. Ability to function is better.
b. Many artists and writers contribute significantly
5. Other features
a. Sleep reduced
b. Insight Absent
c. Mood Incongruent psychotics features may be present
6. Absence of Underlying Organic Cause

Explanation
1. Other than that he takes Alcohol, no other feature supports Alcohol dependence.
2. Schizophrenia rarely presents like this.
3. Mania is the correct diagnosis for this patient. We can see that all the features that are seen in this patient are the ones seen in Mania
4. Impulsive control disorder does not present like this. Please look at the other question for Impulse control disorders

Comments
If you cannot match the answer at the first attempt, try exclusion of the other choices. But keep in mind that there are negative marks in these exams !!

Tips
Mania and Depression along with Schizophrenia, Delusion, Hallucination, Drug dependence are the common topics from which you will get questions and these question will be answered by the majority and if you leave a question in these topics, you may be left out in the race


Explanation By Dr Bruno, Author of

Author Dr Bruno, Publisher Jaypee



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