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22 Cards in this Set
- Front
- Back
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Substance Dependence
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A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
(1) tolerance, as defined by either of the following: (a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect (b) markedly diminished effect with continued use of the same amount of the substance (2) withdrawal, as manifested by either of the following: (a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances) (b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms (3) the substance is often taken in larger amounts or over a longer period than was intended (4) there is a persistent desire or unsuccessful efforts to cut down or control substance use (5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects (6) important social, occupational, or recreational activities are given up or reduced because of substance use (7) the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption) Specify if: With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present) Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present) |
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Substance Abuse
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A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
(1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) (2) recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use) (3) recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct) (4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) B. The symptoms have never met the criteria for Substance Dependence for this class of substance. |
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Substance Intoxication
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A. The development of a reversible substance-specific syndrome due to recent ingestion of (or exposure to) a substance. Note: Different substances may produce similar or identical syndromes.
B. Clinically significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system (e.g., belligerence, mood lability, cognitive impairment, impaired judgment, impaired social or occupational functioning) and develop during or shortly after use of the substance. C. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Substance Withdrawal
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A. The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy and prolonged.
B. The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Alcohol Intoxication
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A. Recent ingestion of alcohol.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after, alcohol ingestion. C. One (or more) of the following signs, developing during, or shortly after, alcohol use: (1) slurred speech (2) incoordination (3) unsteady gait (4) nystagmus (5) impairment in attention or memory (6) stupor or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Alcohol Withdrawal
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A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. Two (or more) of the following, developing within several hours to a few days after Criterion A: (1) autonomic hyperactivity (e.g., sweating or pulse rate greater than 100) (2) increased hand tremor (3) insomnia (4) nausea or vomiting (5) transient visual, tactile, or auditory hallucinations or illusions (6) psychomotor agitation (7) anxiety (8) grand mal seizures C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Amphetamine Intoxication
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A. Recent use of amphetamine or a related substance (e.g., methylphenidate).
B. Clinically significant maladaptive behavioral or psychological changes (e.g., euphoria or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment; or impaired social or occupational functioning) that developed during, or shortly after, use of amphetamine or a related substance. C. Two (or more) of the following, developing during, or shortly after, use of amphetamine or a related substance: (1) tachycardia or bradycardia (2) pupillary dilation (3) elevated or lowered blood pressure (4) perspiration or chills (5) nausea or vomiting (6) evidence of weight loss (7) psychomotor agitation or retardation (8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias (9) confusion, seizures, dyskinesias, dystonias, or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Amphetamine Withdrawal
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A. Cessation of (or reduction in) amphetamine (or a related substance) use that has been heavy and prolonged.
B. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A: (1) fatigue (2) vivid, unpleasant dreams (3) insomnia or hypersomnia (4) increased appetite (5) psychomotor retardation or agitation C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Caffeine Intoxication
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A. Recent consumption of caffeine, usually in excess of 250 mg (e.g., more than 2-3 cups of brewed coffee).
B. Five (or more) of the following signs, developing during, or shortly after, caffeine use: (1) restlessness (2) nervousness (3) excitement (4) insomnia (5) flushed face (6) diuresis (7) gastrointestinal disturbance (8) muscle twitching (9) rambling flow of thought and speech (10) tachycardia or cardiac arrhythmia (11) periods of inexhaustibility (12) psychomotor agitation C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder (e.g., an Anxiety Disorder). |
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Cannabis Intoxication
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A. Recent use of cannabis.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal) that developed during, or shortly after, cannabis use. C. Two (or more) of the following signs, developing within 2 hours of cannabis use: (1) conjunctival injection (2) increased appetite (3) dry mouth (4) tachycardia D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Cocaine Intoxication
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A. Recent use of cocaine.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., euphoria or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment; or impaired social or occupational functioning) that developed during, or shortly after, use of cocaine. C. Two (or more) of the following, developing during, or shortly after, cocaine use: (1) tachycardia or bradycardia (2) pupillary dilation (3) elevated or lowered blood pressure (4) perspiration or chills (5) nausea or vomiting (6) evidence of weight loss (7) psychomotor agitation or retardation (8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias (9) confusion, seizures, dyskinesias, dystonias, or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Cocaine Withdrawal
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A. Cessation of (or reduction in) cocaine use that has been heavy and prolonged.
B. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A: (1) fatigue (2) vivid, unpleasant dreams (3) insomnia or hypersomnia (4) increased appetite (5) psychomotor retardation or agitation C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Hallucinogen Intoxication
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A. Recent use of a hallucinogen.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., marked anxiety or depression, ideas of reference, fear of losing one's mind, paranoid ideation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, hallucinogen use. C. Perceptual changes occurring in a state of full wakefulness and alertness (e.g., subjective intensification of perceptions, depersonalization, derealization, illusions, hallucinations, synesthesias) that developed during, or shortly after, hallucinogen use. D. Two (or more) of the following signs, developing during, or shortly after, hallucinogen use: (1) pupillary dilation (2) tachycardia (3) sweating (4) palpitations (5) blurring of vision (6) tremors (7) incoordination E. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Hallucinogen Persisting Perception Disorder (Flashbacks)
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A. The reexperiencing, following cessation of use of a hallucinogen, of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e.g., geometric hallucinations, false perceptions of movement in the peripheral visual fields, flashes of color, intensified colors, trails of images of moving objects, positive afterimages, halos around objects, macropsia, and micropsia).
B. The symptoms in Criterion A cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The symptoms are not due to a general medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better accounted for by another mental disorder (e.g., delirium, dementia, Schizophrenia) or hypnopompic hallucinations. |
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Inhalant Intoxication
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A. Recent intentional use or short-term, high-dose exposure to volatile inhalants (excluding anesthetic gases and short-acting vasodilators).
B. Clinically significant maladaptive behavioral or psychological changes (e.g., belligerence, assaultiveness, apathy, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after, use of or exposure to volatile inhalants. C. Two (or more) of the following signs, developing during, or shortly after, inhalant use or exposure: (1) dizziness (2) nystagmus (3) incoordination (4) slurred speech (5) unsteady gait (6) lethargy (7) depressed reflexes (8) psychomotor retardation (9) tremor (10) generalized muscle weakness (11) blurred vision or diplopia (12) stupor or coma (13) euphoria D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Nicotine Withdrawal
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A. Daily use of nicotine for at least several weeks.
B. Abrupt cessation of nicotine use, or reduction in the amount of nicotine used, followed within 24 hours by four (or more) of the following signs: (1) dysphoric or depressed mood (2) insomnia (3) irritability, frustration, or anger (4) anxiety (5) difficulty concentrating (6) restlessness (7) decreased heart rate (8) increased appetite or weight gain C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Opioid Intoxication
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A. Recent use of an opioid.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, opioid use. C. Pupillary constriction (or pupillary dilation due to anoxia from severe overdose) and one (or more) of the following signs, developing during, or shortly after, opioid use: (1) drowsiness or coma (2) slurred speech (3) impairment in attention or memory D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Opioid Withdrawal
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A. Either of the following:
(1) cessation of (or reduction in) opioid use that has been heavy and prolonged (several weeks or longer) (2) administration of an opioid antagonist after a period of opioid use B. Three (or more) of the following, developing within minutes to several days after Criterion A: (1) dysphoric mood (2) nausea or vomiting (3) muscle aches (4) lacrimation or rhinorrhea (5) pupillary dilation, piloerection, or sweating (6) diarrhea (7) yawning (8) fever (9) insomnia C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Phencyclidine Intoxication (PCP)
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A. Recent use of phencyclidine (or a related substance).
B. Clinically significant maladaptive behavioral changes (e.g., belligerence, assaultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, phencyclidine use. C. Within an hour (less when smoked, "snorted," or used intravenously), two (or more) of the following signs: (1) vertical or horizontal nystagmus (2) hypertension or tachycardia (3) numbness or diminished responsiveness to pain (4) ataxia (5) dysarthria (6) muscle rigidity (7) seizures or coma (8) hyperacusis D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Sedative, Hypnotic, or Anxiolytic Intoxication
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A. Recent use of a sedative, hypnotic, or anxiolytic.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after, sedative, hypnotic, or anxiolytic use. C. One (or more) of the following signs, developing during, or shortly after, sedative, hypnotic, or anxiolytic use: (1) slurred speech (2) incoordination (3) unsteady gait (4) nystagmus (5) impairment in attention or memory (6) stupor or coma D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. |
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Sedative, Hypnotic, or Anxiolytic Withdrawal
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A. Cessation of (or reduction in) sedative, hypnotic, or anxiolytic use that has been heavy and prolonged.
B. Two (or more) of the following, developing within several hours to a few days after Criterion A: (1) autonomic hyperactivity (e.g., sweating or pulse rate greater than 100) (2) increased hand tremor (3) insomnia (4) nausea or vomiting (5) transient visual, tactile, or auditory hallucinations or illusions (6) psychomotor agitation (7) anxiety (8) grand mal seizures C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Specify if: With Perceptual Disturbances |
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Polysubstance Dependence
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This diagnosis is reserved for behavior during the same 12-month period in which the person was repeatedly using at least three groups of substances (not including caffeine and nicotine), but no single substance predominated. Further, during this period, the Dependence criteria were met for substances as a group but not for any specific substance. For example, a diagnosis of Polysubstance Dependence would apply to an individual who, during the same 12-month period, missed work because of his heavy use of alcohol, continued to use cocaine despite experiencing severe depressions after nights of heavy consumption, and was repeatedly unable to stay within his self-imposed limits regarding his use of codeine. In this instance, although the problems associated with the use of any one substance were not pervasive enough to justify a diagnosis of Dependence, his overall use of substances significantly impaired his functioning and thus warranted a diagnosis of Dependence on the substances as a group. Such a pattern might be observed, for example, in a setting where substance use was highly prevalent but where the drugs of choice changed frequently. For those situations in which there is a pattern of problems associated with multiple drugs and the criteria are met for more than one specific Substance-Related Disorder (e.g., Cocaine Dependence, Alcohol Dependence, and Cannabis Dependence), each diagnosis should be made.
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