Differentials
Other psychiatric disorders
SIGNS / SYMPTOMS
Symptoms of alcohol-use disorder (including those of intoxication/withdrawal) may be confused with symptoms of other psychiatric disorders. Furthermore, several psychiatric disorders (e.g., schizophrenia, bipolar disorder, PTSD) can co-occur with alcohol-use disorder.
Differentiating signs and symptoms depend on the type of psychiatric disorder present. Definitive diagnosis is often difficult and requires multiple visits. Observation over weeks to months may be necessary to clarify underlying psychiatric diagnoses. However, co-treatment generally has better outcomes than waiting for patients to stop drinking before making a diagnosis or starting psychiatric treatment, and therefore treatment should not be withheld until patients stop drinking.
Other substance use disorders (especially sedatives)
SIGNS / SYMPTOMS
Sedating substances or medications (e.g., benzodiazepines, barbiturates, opioids, muscle relaxers) may have similar signs and symptoms as alcohol-use disorder, or may be used together with alcohol.
Use of these substances with alcohol may pose a risk for overdose complications (e.g., respiratory depression).
INVESTIGATIONS
DSM-5-TR criteria for substance use disorders other than alcohol.[3]
Urine and/or blood toxicologies indicating presence of other substances is not diagnostic.
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