ABSTRACT
In considering psychiatric problems in addicts, we rapidly reach the unanswered enigma encompassed by “Which came first, the chicken or the egg?”. It is clear, however, that in adhering to the rigid diagnostic criteria of the American Psychiatric Association (DSM IH-R), 1 there are many aberrations from normal encountered in substance-abusing patients. The loss of brain mass as indicated by CT scan or MRI is widespread, but is discussed in Chapter 17. 2 A recent series of papers testing the regional glucose metabolism of the brain has found that chronic alcoholics without apparent central nervous system disease have striking regional differences in glucose metabolism. This is even more marked in those with forgetfulness and may be an important feature in the psychiatric as well as the neurological features of these patients. 3 Table 36 lists the several types of problems that will be discussed in this chapter. 4
