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Verslaving - SheetNotes (2017/2018)

Hoorcollegeaantekeningen 17/18

Drugsgebruik onder de 21 jaar komt het meeste voor in Nederland.

Verslaving is de meest voorkomende psychiatrische diagnose (nog afgezien van nicotineverslaving).

Verslaving: prevalenties

  • Probleemgebruikers van harddrugs in Nederland rond de 34.000 (2% van de bevolking)

  • Aantal cannabis verslaafden is in afgelopen 10 jaar egstegen van 3500 in 2000 naar bijna 11000 in 2010.

  • 85% van de Nederlanders van 16 jaar en ouder drinkt regelmatig een glas alcohol

  • 8.3% v.s. 3% van 19jarige mannen t.o.v. vrouwen; 2% van 20-24 jarigen is alcoholafhankelijk

Man – vrouw verschillen in middelengebruik

Mannen

vs. Vrouwen

Lifetime: 30%

vs. 7%

Sneller verslaving, sneller bij

< Gebruik medische complicaties

Vaker gebruik om de kick Vaker gebruik tegen negatieve emoties

Vaker angst en depressief

Man – vrouw verschillen in behavioral addiction

Mannen

vs. Vrouwen

Gokken buying

Stealing

Seks

Binge eating

Pyromanie

Kleptomanie

Overlap met compulsief gedrag:

…..

 

 

DSM-V: verslaving en afhankelijkheid

Waarom? Middel zelf zit niet in de definitie.

DSM-V: afhankelijkheid

  • Aan een middel gebonden stoornissen

  • Stoornissen in het gebruik van een middel

    • Afhankelijkheid van een middel

    • Misbruik van een middel

  • Stoornissen door het gebruik van een middel

    • Intoxxicatie

    • Onthouding

    • Delirium

Afhankelijkheid van een middel: >3 kenmerken in 12 maanden.

  • Tolerantie (steeds meer nodig)

  • Onthoudingsverschijnselen (slapeloosheid, kater, koorts… bij stoppen; vergelijkbaar middel gebruiken om onthouding tegen te gaan).

  • Meer nemen dan de bedoeling was

  • Willen stoppen, (mislukte) poging

  • Het verkrijgen en/of gebruiken kost veel tijd

  • Ten koste van sociale activiteiten, werk en/of vrijetijdsbesting

  • Doorgaan ook al kent men de psychologische en lichamelijke risico’s

Volgens DSM-5 specificeren

  • Wel/geen lichamelijke afhankelijkheid (1,2)

  • Beloop:

    • Early full (1-11 mnd) remission

    • Early partial remission (1-11 mnd)

    • Sustained full remission (>11 mnd)

    • Sustained partial remission (>11 mnd)

Remissie: tijdelijke vermindering of verdwijning van ziekteverschijnselen.

Behavioral addictions:

  • Gokverslaving

  • Chatverslaving

  • Internetverslaving

  • Gameverslaving

  • Seksverslaving

  • Workaholisme

  • Eetverslaving

  • Nagelbijten

  • Koopverslaving

  • Relatie verslaving

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