本当はDSM-IVでは、caffeineに関してはdependenceは定義されないのだが、まあ、そこら辺は話をおもしろくするために、大目にみよう。一端dependenceの診断を受けたら、一生、その物質に関しては依存状態にあると定義される。
だから仮にcaffeineに関してdependenceが存在したとしたら、僕は、「dependence with sustained partial remission」ということになるだろう。大学の頃は、まさしくこの通りだった...
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
- tolerance, as defined by either of the following:
(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect (該当)
(b) markedly diminished effect with continued use of the same amount of the substance (該当) - withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances) (該当)
(b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms (該当) - the substance is often taken in larger amounts or over a longer period than was intended (該当)
- there is a persistent desire or unsuccessful efforts to cut down or control substance use (該当)
- a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects (該当)
- important social, occupational, or recreational activities are given up or reduced because of substance use (該当せず...自覚がないだけだったか?)
- the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption) (該当)
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