Dementia Associated with Alcoholism
            European Description
    

The ICD-10 Classification of Mental and Behavioural Disorders
World Health Organization, Geneva, 1992

 
F10.7 Residual And Late-Onset Psychotic Disorder
A disorder in which alcohol- or psychoactive substance-induced changes of 
cognition, affect, personality, or behaviour persist beyond the period during 
which a direct psychoactive substance-related effect might reasonably be assumed 
to be operating. 
Diagnostic Guidelines
Onset of the disorder should be directly related to the use of alcohol or a 
psychoactive substance. Cases in which initial onset occurs later than 
episode(s) of substance use should be coded here only where clear and strong 
evidence is available to attribute the state to the residual effect of the 
substance. The disorder should represent a change from or marked exaggeration of 
prior and normal state of functioning. 
The disorder should persist beyond any period of time during which direct 
effects of the psychoactive substance might be assumed to be operative (see 
F1x.0, acute intoxication). Alcohol- or psychoactive substance-induced dementia 
is not always irreversible; after an extended period of total abstinence, 
intellectual functions and memory may improve. 
The disorder should be carefully distinguished from withdrawal-related 
conditions (see F1x.3 and F1x.4). It should be remembered that, under certain 
conditions and for certain substances, withdrawal state phenomena may be present 
for a period of many days or weeks after discontinuation of the substance. 
Conditions induced by a psychoactive substance, persisting after its use, and 
meeting the criteria for diagnosis of psychotic disorder should not be diagnosed 
here (use F1x.5, psychotic disorder). Patients who show the chronic end-state of 
Korsakov's syndrome should be coded under F1x.6. 
Differential Diagnosis
Consider: pre-existing mental disorder masked by substance use and re-emerging 
as psychoactive substance-related effects fade (for example, phobic anxiety, a 
depressive disorder, schizophrenia, or schizotypal disorder). In the case of 
flashbacks, consider acute and transient psychotic disorders (F23.-). Consider 
also organic injury and mild or moderate mental retardation (F70-F71), which may 
coexist with psychoactive substance misuse. 
This diagnostic rubric may be further subdivided by using the following 
five-character codes: 
F1x.70 Flashbacks
May be distinguished from psychotic disorders partly by their episodic nature, 
frequently of very short duration (seconds or minutes) and by their duplication 
(sometimes exact) of previous drug-related experiences. 
F1x.71 Personality or behaviour disorder
Meeting the criteria for organic personality disorder (F07.0). 
F1x.72 Residual affective disorder
Meeting the criteria for organic mood [affective] disorders (F06.3). 
F1x.73 Dementia
Meeting the general criteria for dementia as outlined in the introduction to 
F00-F09. 
F1x.74 Other persisting cognitive impairment
A residual category for disorders with persisting cognitive impairment, which do 
not meet the criteria for psychoactive substance-induced amnesic syndrome 
(F1x.6) or dementia (F1x.73). 
F1x.75 Late-onset psychotic disorder 


ICD-10 copyright © 1992 by World Health Organization.
Internet Mental Health (www.mentalhealth.com) copyright © 1995-1997 by Phillip 
W. Long, M.D.