Substance or medication induced psychotic disorder
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Synonyms and keywords: Medication-induced psychotic disorder; Substance-induced psychotic disorder; Substance/medication-induced psychotic disorder
Overview
Substance-induced psychotic disorder is defined as hallucinations and/or delusions that occur soon after substance intoxication or withdrawal and that are not better explained by a psychotic disorder.
Differential Diagnosis
- Alcohol withdrawal
- Brief psychotic disorder
- Cannabis intoxication
- Delusional disorder
- Flashback hallucinations
- Intoxication with stimulants
- Phencyclidine
- Schizophrenia
- Schizoaffective disorder
- Schizophrenia spectrum
- Delusional disorder
- Meperidine use[1]
Risk Factors
Prognosis
Poor prognostic factors include:
- Depersonalization
- Flashbacks
- Hallucinations
- Marked anxiety
- Persecutory delusions[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Substance/Medication-induced Psychotic Disorder
- A. Presence of one or both of the following symptoms:
- 1. Delusions
AND
- B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):
- 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
- 2. The involved substance/medication is capable of producing the symptoms in Criterion A.
AND
- C. The disturbance is not better explained by a psychotic disorder that is not substance/medication-induced. Such evidence of an independent psychotic disorder could include the following:
The symptoms preceded the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication: or there is other evidence of an independent non-substance/medication-induced psychotic disorder (e.g., a history of recurrent non-substance/medication-related episodes).
AND
- D. The disturbance does not occur exclusively during the course of a delirium.
AND
- E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Note: This diagnosis should be made instead of a diagnosis of substance intoxication or substance withdrawal only when the symptoms in Criterion A predominate in the clinical picture and when they are sufficiently severe to warrant clinical attention.
References
- ↑ 1.0 1.1 1.2 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.