Substance or medication-induced obsessive-compulsive disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Differential Diagnosis

• Delirium
• Obsessive-compulsive and related disorder (i.e., not induced by a substance)
• Obsessive-compulsive and related disorder due to another medical condition
• Substance intoxication

Diagnostic Criteria

DSM-V Diagnostic Criteria for Substance/Medication-Induced Obsessive-Compulsive and Related Disorder

“

A. Obsessions, compulsions, skin picking, hair pulling, other body-focused repetitive behaviors,or other symptoms characteristic of the obsessive-compulsive and related disorders predominate in the clinical picture. 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 an obsessive-compulsive and related disorder that is not substance/medication-induced. Such evidence of an independent obsessive-compulsive and related disorder could include the following: The symptoms precede 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 suggesting the existence of an independent non-substance/medication-induced obsessive-compulsive and related 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 in addition to a diagnosis of substance intoxication or substance withdrawal only when the symptoms in Criterion A predominate in the clinical picture and are sufficiently severe to warrant clinical attention.

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References

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