Speaker(s):
Presentation: Ms. T is a 27-year-old Caucasian female with a past medical history of bipolar disorder with psychotic features, methamphetamine use disorder and cannabis use disorder admitted to our forensic inpatient unit after she was found incompetent to stand trial on charges of burglary and stealing related offense. She was misusing multiple substances including methamphetamine, marijuana, inhalants, opioids and benzodiazepines on daily basis for several years starting at the age of 18 until incarceration a few months before the current admission. Her main presenting symptoms including mood symptoms and anxiety were well controlled during first month of hospitalization with medication regimen of oral valproic acid 1000mg at bed time for mood stabilization and oral paliperidone 6mg daily for psychosis. However, cognitive deficits of memory and attention became apparent gradually. Psychology testing demonstrated impairment in multiple cognitive domains. Medical diagnoses as cause of cognitive impairment were excluded with the help of laboratory testing and MRI brain. She was finally given diagnosis of Substance/Medication-Induced Major Neurocognitive Disorder. This presentation gives an overview of this case followed by discussion of diagnostic criteria and risk factors of substance induced neurocognitive disorder with a brief view of cognitive deficits due to few specific substances, consequences of cognitive impairment and lastly, therapeutic strategies.
Objectives:
- Review DSM 5 criteria for Substance/Medication-Induced Major Neurocognitive Disorder
- Identify risk factors for Substance/Medication-Induced Major Neurocognitive Disorder
- Describe cognitive deficits caused by few commonly misused substances
- Identify feasible therapeutic strategies that can be acquired to help patients