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DSM-IV - Substance-Induced Mood Disorder


[From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000.] ...

  1. A prominent and persistent disturbance in mood predominates in the clinical picture and is characterized by either (or both) of the following:
    1. depressed mood or markedly diminished interest or pleasure in all, or almost all, activities
    2. elevated, expansive, or irritable mood
  2. There is evidence from the history, physical examination, or laboratory findings of either (1) or (2):
    1. the symptoms in Criterion A developed during, or within a month of, substance intoxication or withdrawal
    2. medication use is etiologically related to the disturbance
  3. The disturbance is not better accounted for by a mood disorder that is not substance induced. Evidence that the symptoms are better accounted for by a mood disorder that is not substance-induced might include the following: the symptoms precede the onset of the substance use (or medication use); the symptoms persist for a substantial period of time (e.g., about a month) after the cessation of acute withdrawal or severe intoxication or are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use; or there is other evidence that suggests the existence of an independent non–substance-induced mood disorder (e.g., a history of recurrent major depressive episodes).
  4. The disturbance does not occur exclusively during the course of a delirium.
  5. The symptoms cause 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 mood symptoms are in excess of those usually associated with the intoxication or withdrawal syndrome and when the symptoms are sufficiently severe to warrant independent clinical attention. Code [Specific substance]-induced mood disorder:
Alcohol; amphetamine [or amphetamine-like substance]; cocaine; hallucinogen; inhalant; opioid; phencyclidine [or phencyclidine-like substance]; sedative, hypnotic, or anxiolytic; other [or unknown] substance
Specify type:
With depressive features: if the predominant mood is depressed
With manic features: if the predominant mood is elevated, euphoric, or irritable
With mixed features: if symptoms of both mania and depression are present and neither predominates
Specify if:
With onset during intoxication: if the criteria are met for intoxication with the substance and the symptoms develop during the intoxication syndrome
With onset during withdrawal: if criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, a withdrawal syndrome

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