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20 Cards in this Set
- Front
- Back
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Major Depressive Episode
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A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. (1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others) (3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. (4) insomnia or hypersomnia nearly every day (5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) (6) fatigue or loss of energy nearly every day (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) (8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) (9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide B. The symptoms do not meet criteria for a Mixed Episode (see page 365). C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. |
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Manic Episode
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A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: (1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The symptoms do not meet criteria for a Mixed Episode (see page 365). D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder. |
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Mixed Episode
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A. The criteria are met both for a Manic Episode (see page 362) and for a Major Depressive Episode (see page 356) (except for duration) nearly every day during at least a 1-week period.
B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Note: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder. |
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Hypomanic Episode
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A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: (1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. D. The disturbance in mood and the change in functioning are observable by others. E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. F. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder. |
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Major Depressive Disorder, Single Episode
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A. Presence of a single Major Depressive Episode (see page 356).
B. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. C. There has never been a Manic Episode (see page 362), a Mixed Episode (see page 365), or a Hypomanic Episode (see page 368). Note: This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition. If the full criteria are currently met for a Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Major Depressive Episode, specify the current clinical status of the Major Depressive Disorder or features of the most recent episode: In Partial Remission, In Full Remission (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) |
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Major Depressive Disorder, Recurrent
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A. Presence of two or more Major Depressive Episodes (see page 356).
Note: To be considered separate episodes, there must be an interval of at least 2 consecutive months in which criteria are not met for a Major Depressive Episode. B. The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. C. There has never been a Manic Episode (see page 362), a Mixed Episode (see page 365), or a Hypomanic Episode (see page 368). Note: This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition. If the full criteria are currently met for a Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/ Severe With Psychotic Features (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Major Depressive Episode, specify the current clinical status of the Major Depressive Disorder or features of the most recent episode: In Partial Remission, In Full Remission (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (see page 425) |
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Dysthymic Disorder
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A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following: (1) poor appetite or overeating (2) insomnia or hypersomnia (3) low energy or fatigue (4) low self-esteem (5) poor concentration or difficulty making decisions (6) feelings of hopelessness C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time. D. No Major Depressive Episode (see page 356) has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission. Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode. E. There has never been a Manic Episode (see page 362), a Mixed Episode (see page 365), or a Hypomanic Episode (see page 368), and criteria have never been met for Cyclothymic Disorder. F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder. G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: Early Onset: if onset is before age 21 years Late Onset: if onset is age 21 years or older Specify (for most recent 2 years of Dysthymic Disorder): With Atypical Features (see page 420) |
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Depressive Disorder NOS
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The Depressive Disorder Not Otherwise Specified category includes disorders with depressive features that do not meet the criteria for Major Depressive Disorder, Dysthymic Disorder, Adjustment Disorder With Depressed Mood (see page 679), or Adjustment Disorder With Mixed Anxiety and Depressed Mood (see page 680). Sometimes depressive symptoms can present as part of an Anxiety Disorder Not Otherwise Specified (see page 484). Examples of Depressive Disorder Not Otherwise Specified include
1. Premenstrual dysphoric disorder: in most menstrual cycles during the past year, symptoms (e.g., markedly depressed mood, marked anxiety, marked affective lability, decreased interest in activities) regularly occurred during the last week of the luteal phase (and remitted within a few days of the onset of menses). These symptoms must be severe enough to markedly interfere with work, school, or usual activities and be entirely absent for at least 1 week postmenses (see page 771 for suggested research criteria). 2. Minor depressive disorder: episodes of at least 2 weeks of depressive symptoms but with fewer than the five items required for Major Depressive Disorder (see page 775 for suggested research criteria). 3. Recurrent brief depressive disorder: depressive episodes lasting from 2 days up to 2 weeks, occurring at least once a month for 12 months (not associated with the menstrual cycle) (see page 778 for suggested research criteria). 4. Postpsychotic depressive disorder of Schizophrenia: a Major Depressive Episode that occurs during the residual phase of Schizophrenia (see page 767 for suggested research criteria). 5. A Major Depressive Episode superimposed on Delusional Disorder, Psychotic Disorder Not Otherwise Specified, or the active phase of Schizophrenia. 6. Situations in which the clinician has concluded that a depressive disorder is present but is unable to determine whether it is primary, due to a general medical condition, or substance induced. |
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Bipolar I Disorder
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Presence of one (or more) manic episodes or one (or more) mixed episodes. Many also experience major depressive episodes.
Episodes of Substance-Induced Mood Disorder or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Bipolar I Disorder. |
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Bipolar I Disorder, Single Manic Episode
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A. Presence of only one Manic Episode (see page 362) and no past Major Depressive Episodes.
Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms. B. The Manic Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Specify if: Mixed: if symptoms meet criteria for a Mixed Episode (see page 365) If the full criteria are currently met for a Manic, Mixed, or Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 410) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Manic, Mixed, or Major Depressive Episode, specify the current clinical status of the Bipolar I Disorder or features of the most recent episode: In Partial Remission, In Full Remission (see page 410) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) |
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Bipolar I Disorder, Most Recent Episode Hypomanic
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A. Currently (or most recently) in a Hypomanic Episode (see page 368).
B. There has previously been at least one Manic Episode (see page 362) or Mixed Episode (see page 365). C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Bipolar I Disorder, Most Recent Episode Manic
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A. Currently (or most recently) in a Manic Episode (see page 362).
B. There has previously been at least one Major Depressive Episode (see page 356), Manic Episode (see page 362), or Mixed Episode (see page 365). C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. If the full criteria are currently met for a Manic Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 413) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Manic Episode, specify the current clinical status of the Bipolar I Disorder and/or features of the most recent Manic Episode: In Partial Remission, In Full Remission (see page 414) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Bipolar I Disorder, Most Recent Episode Mixed
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A. Currently (or most recently) in a Mixed Episode (see page 365).
B. There has previously been at least one Major Depressive Episode (see page 356), Manic Episode (see page 362), or Mixed Episode (see page 365). C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. If the full criteria are currently met for a Mixed Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 415) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Mixed Episode, specify the current clinical status of the Bipolar I Disorder and/or features of the most recent Mixed Episode: In Partial Remission, In Full Remission (see page 416) With Catatonic Features (see page 417) With Postpartum Onset (see page 422) Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Bipolar I Disorder, Most Recent Episode Depressed
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A. Currently (or most recently) in a Major Depressive Episode (see page 356).
B. There has previously been at least one Manic Episode (see page 362) or Mixed Episode (see page 365). C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. If the full criteria are currently met for a Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) If the full criteria are not currently met for a Major Depressive Episode, specify the current clinical status of the Bipolar I Disorder and/or features of the most recent Major Depressive Episode: In Partial Remission, In Full Remission (see page 411) Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Bipolar I Disorder, Most Recent Episode Unspecified
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A. Criteria, except for duration, are currently (or most recently) met for a Manic (see page 362), a Hypomanic (see page 368), a Mixed (see page 365), or a Major Depressive Episode (see page 356).
B. There has previously been at least one Manic Episode (see page 362) or Mixed Episode (see page 365). C. The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. E. The mood symptoms in Criteria A and B are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Bipolar II Disorder
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A. Presence (or history) of one or more Major Depressive Episodes (see page 356).
B. Presence (or history) of at least one Hypomanic Episode (see page 368). C. There has never been a Manic Episode (see page 362) or a Mixed Episode (see page 365). D. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify current or most recent episode: Hypomanic: if currently (or most recently) in a Hypomanic Episode (see page 368) Depressed: if currently (or most recently) in a Major Depressive Episode (see page 365) If the full criteria are currently met for a Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features (see page 411) Note: Fifth-digit codes specified on page 413 cannot be used here because the code for Bipolar II Disorder already uses the fifth digit. Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 417) With Atypical Features (see page 419) With Postpartum Onset (see page 420) If the full criteria are not currently met for a Hypomanic or Major Depressive Episode, specify the clinical status of the Bipolar II Disorder and/or features of the most recent Major Depressive Episode (only if it is the most recent type of mood episode): In Partial Remission, In Full Remission (see page 411) Note: Fifth-digit codes specified on page 413 cannot be used here because the code for Bipolar II Disorder already uses the fifth digit. Chronic (see page 417) With Catatonic Features (see page 417) With Melancholic Features (see page 419) With Atypical Features (see page 420) With Postpartum Onset (see page 422) Specify: Longitudinal Course Specifiers (With and Without Interepisode Recovery) (see page 424) With Seasonal Pattern (applies only to the pattern of Major Depressive Episodes) (see page 425) With Rapid Cycling (see page 427) |
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Cyclothymic Disorder
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A. For at least 2 years, the presence of numerous periods with hypomanic symptoms (see page 368) and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode. Note: In children and adolescents, the duration must be at least 1 year.
B. During the above 2-year period (1 year in children and adolescents), the person has not been without the symptoms in Criterion A for more than 2 months at a time. C. No Major Depressive Episode (page 365), Manic Episode (page 362), or Mixed Episode (see page 365) has been present during the first 2 years of the disturbance. Note: After the initial 2 years (1 year in children and adolescents) of Cyclothymic Disorder, there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be diagnosed). D. The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism). F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
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Bipolar Disorder NOS
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The Bipolar Disorder Not Otherwise Specified category includes disorders with bipolar features that do not meet criteria for any specific Bipolar Disorder. Examples include
1. Very rapid alternation (over days) between manic symptoms and depressive symptoms that meet symptom threshold criteria but not minimal duration criteria for Manic, Hypomanic, or Major Depressive Episodes 2. Recurrent Hypomanic Episodes without intercurrent depressive symptoms 3. A Manic or Mixed Episode superimposed on Delusional Disorder, residual Schizophrenia, or Psychotic Disorder Not Otherwise Specified 4. Hypomanic Episodes, along with chronic depressive symptoms, that are too infrequent to qualify for a diagnosis of Cyclothymic Disorder 5. Situations in which the clinician has concluded that a Bipolar Disorder is present but is unable to determine whether it is primary, due to a general medical condition, or substance induced |
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Mood Disorder Due to . . . [Indicate the General Medical Condition]
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A. 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 B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition. C. The disturbance is not better accounted for by another mental disorder (e.g., Adjustment Disorder With Depressed Mood in response to the stress of having a general medical condition). D. The disturbance does not occur exclusively during the course of a delirium. E. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify type: With Depressive Features: if the predominant mood is depressed but the full criteria are not met for a Major Depressive Episode With Major Depressive-Like Episode: if the full criteria are met (except Criterion D) for a Major Depressive Episode (see page 365) With Manic Features: if the predominant mood is elevated, euphoric, or irritable With Mixed Features: if the symptoms of both mania and depression are present but neither predominates [Indicate the General Medical Condition] Coding note: Include the name of the general medical condition on Axis I, e.g., 293.83 Mood Disorder Due to Hypothyroidism, With Depressive Features; also code the general medical condition on Axis III (see Appendix G for codes). Coding note: If depressive symptoms occur as part of a preexisting Vascular Dementia, indicate the depressive symptoms by coding the appropriate subtype, i.e., 290.43 Vascular Dementia, With Depressed Mood. |
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Substance-Induced Mood Disorder (Specify Substance)
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A. 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 B. 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 C. 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). D. The disturbance does not occur exclusively during the course of a delirium. E. 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: (291.89 Alcohol; 292.84 Amphetamine [or Amphetamine-Like Substance]; 292.84 Cocaine; 292.84 Hallucinogen; 292.84 Inhalant; 292.84 Opioid; 292.84 Phencyclidine [or Phencyclidine-Like Substance]; 292.84 Sedative, Hypnotic, or Anxiolytic; 292.84 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 (see Table 1 on page 193 for applicability by substance): 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 |
