Sandbox/JRH
1.- Substance/Medication-Induced Psychotic Disorder
Synonyms and keywords: Medication induced psychotic disorder; substance induced psychotic disorder; substance-medication induced 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
- Opioid meperidine[1]
Epidemiology and Demographics
Prevalence
The prevalence of substance/medication-induced psychotic disorder is unknown of the overall population.[1]
Risk Factors
Natural History, Complications and Prognosis
Poor prognosis factors include:
- Depersonalization
- Flashbacks
- Hallucinations
- Marked anxiety
- Persecutory delusions[1]
Diagnostic Criteria
- 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
2.- Catatonia Associated With Another Mental Disorder (Catatonia Specifier)
Synonyms and keywords: Catatonia
Epidemiology and Demographics
Prevalence
The prevalence of catatonia associated with another mental disorder is unknown of the overall population.[1]
Risk Factors
- Bipolar disorders
- Depressive disorders
- Schizophrenia[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
- Bipolar disorder
- Depressive disorder
- Mental disorder
- Metabolic conditions
- Infectious conditions
- Psychotic disorder[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Catatonic Disorder Due to Another IVIedical Condition[1]
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References
3. Catatonic Disorder Due to Another Medical Condition
Differential Diagnosis
- Brief psychotic disorder
- Cerebrovascular disease
- Diabetic ketoacidosis
- Encephalitis
- Neoplasms
- Head trauma
- Hepatic encephalopathy
- Hypercalcemia
- Homocystinuria
- Schizoaffective disorder
- Schizophrenia
- Schizophreniform disorder
- Substance/medication-induced psychotic disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of catatonia associated with another medical disorder is unknown of the overall population.[1]
Risk Factors
Natural History, Complications and Prognosis
Poor prognostic factors are:
- Neuroleptic malignant syndrome
- Neuroleptic medication intake[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Paranoid Personality Disorder[1]
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AND
AND
AND
AND
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References
4.- Sleep-Related Hypoventilation
Synonyms and keywords: Obesity hypoventilation disorder
Differential Diagnosis
- Lung diseases
- Skeletal malformations
- Neuromuscular disorders
- Sleep-related hypoxemia
- Obstructive sleep apnea hypopnea
- Central sleep apnea[1]
Epidemiology and Demographics
Prevalence
The prevalence of sleep-related hypoventilation is unknown of the overall population.[1]
Risk Factors
- Central nervous system depressants intake (e.g. benzodiazepines, opioid, alcohol)
- Hypothiroidism
- Neuromuscular or chest wall disorder
- Pulmonary disorder[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic criteria include:
- Central nervous system depressants intake (e.g. benzodiazepines, opioid, alcohol)
- Hypothiroidism
- Neuromuscular or chest wall disorder
- Amyotrophic lateral sclerosis
- Spinal cord injury
- Diaphragmatic paralysis
- Myasthenia gravis
- Lambert-Eaton syndrome
- Toxic or metabolic myopathies
- Postpolio syndrome
- Char-cot-Marie-Tooth syndrome
- Pulmonary disorder[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Paranoid Personality Disorder[1]
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(Note: In the absence of objective measurement of CO2, persistent low levels of hemoglobin oxygen saturation unassociated with apneic/hypopneic events may indicate hypoventilation.)
Specify whether:
Specify current severity:
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References
5.- Non-Rapid Eye Movement Sleep Arousal Disorders
Synonyms and keywords: NREM sleep arousal disorder; sleep terror
Differential Diagnosis
- Alcohol-induced blackouts
- Breathing-related sleep disorders
- Dissociative amnesia, with dissociative fugue
- Sleep-related seizures
- Malingering or other voluntary behavior occurring during wakefulness
- Medication-induced complex behaviors
- REM sleep behavior disorder
- Night eating syndrome
- Nightmare disorder
- Panic disorder
- Parasomnia overlap syndrome[1]
Epidemiology and Demographics
Prevalence
The lifetime prevalence of non-rapid eye movement sleep arousal disorders is 10,000 to 30,000 per 100,000 (10% to 30%) among children. The lifetime prevalence of NREM sleep arousal disorder is 29,200 (29.2%) among adults.[1]
Risk Factors
- Sedative use,
- Sleep deprivation,
- Sleep-wake schedule disruptions
- Fatigue, and physical or emotional stress[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic factors include:
- Emotional stress
- Males during adulthood
- Fatigue
- Females during childhood
- Physical stress
- Sleep-wake schedule disruptions[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Paranoid Personality Disorder[1]
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AND
AND
AND
AND
AND
Specify whether:
Specify if:
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References
6.- Other hallucinogen Use Disorder
Synonyms and keywords:
Differential Diagnosis
- Alcohol withdrawal
- Bipolar disorders
- Central nervous system tumors
- Depressive disorder
- Hypoglycemia
- Panic disorder
- Schizophrenia
- Sedative withdrawal
- Seizure disorder
- Stroke
- Ophthalmological disorder
- Other substance use disorders[1]
Risk Factors
- Alcohol intake
- Tobacco usage
- Cannabis usage
- Major depressive disorder[1]
Epidemiology and Demographics
Prevalence
The 12-month prevalence is 500 per 100,000 (0.5%) among 12- to 17-year-olds and 100 per 100,000 (0.1%) among adults age 18 and older in the United States.[1]
Risk Factors
- Younger age than 30-year-old
- Female gender[1]
Natural History, Complications and Prognosis
Diagnostic Criteria
A. A problematic pattern of hallucinogen (other than phencyclidine) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- The hallucinogen is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control hallucinogen use.
- A great deal of time is spent in activities necessary to obtain the hallucinogen, use the hallucinogen, or recover from its effects.
- Craving, or a strong desire or urge to use the hallucinogen.
- Recurrent hallucinogen use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to hallucinogen use; hallucinogen-related absences, suspensions, or expulsions from school; neglect of children or household).
- Continued hallucinogen use despite having persistent or recurrent social or inter personal problems caused or exacerbated by the effects of the hallucinogen (e.g., arguments with a spouse about consequences of intoxication; physical fights).
- Important social, occupational, or recreational activities are given up or reduced be cause of hallucinogen use.
- Recurrent hallucinogen use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by the hallucinogen).
- hallucinogen use is continued despite knowledge of having a persistent or recur rent physical or psychological problem that is likely to have been caused or exacerbated by the hallucinogen.
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the hallucinogen to achieve intoxication or desired effect.
- A markedly diminished effect with continued use of the same amount of the hallucinogen.
Note: Withdrawal symptoms and signs are not established for hallucinogens, and so this criterion does not apply.
Specify the particular hallucinogen.
Specify if:
- In early remission: After full criteria for other hallucinogen use disorder were previously met, none of the criteria for other hallucinogen use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the hallucinogen,” may be met).
- In sustained remission: After full criteria for other hallucinogen use disorder were previously met, none of the criteria for other hallucinogen use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the hallucinogen,” may be met).
Specify if: In a controlled environment: This additional specifier is used if the individual is in an environment where access to hallucinogens is restricted.
Specify current severity:
- Mild: Presence of 2-3 symptoms.
- Moderate: Presence of 4-5 symptoms.
- Severe: Presence of 6 or more symptoms.
References
7.- Hallucinogen Persisting Perception Disorder
Synonyms and keywords:
Differential Diagnosis
- Brain tumors
- Head trauma
- Infections
- Neurodegenerative disorders
- Schizophrenia
- Stroke[1]
Epidemiology and Demographics
Prevalence
The prevalence of is 4,200 per 100,000 (4.2%) of the overall population.[1]
Risk Factors
- Genetic factors are suggested as a possible factor that leads to susceptibility for this condition.[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic factors include:
- Alcohol use disorder
- Major depressive disorder
- Panic disorder[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Hallucinogen Persisting Perception Disorder[1]
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AND
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References
8.-Stimulant Use Disorder
Synonyms and keywords:
Differential Diagnosis
- Depressive and bipolar disorder
- Generalized anxiety disorder
- Schizophrenia
- Stimulant intoxication
- Stimulant withdrawal
- Panic disorder
- Phencyclidine intoxication[1]
Epidemiology and Demographics
Prevalence
The prevalence of stimulant use disorder is 2,000 per 100,000 (0.2%) of the overall population.[1]
Risk Factors
- Adult antisocial personality disorder
- Antisocial personality disorder
- Bipolar disorder
- Childhood conduct disorder
- Exposure to community violence during childhood
- Schizophrenia
- Substance use disorder
- Impulsivity
- Prenatal cocaine exposure,
- Postnatal cocaine use by parents
- Unstable home environment, having a psychiatric condition[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic factors include:
- Antisocial personality
- Impulsivity
- Substance use disorders
- Living in an unstable home environment[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Stimulant Use Disorder[1]
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A. A pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
This criterion is not considered to be met for those taking stimulant medications solely under appropriate medical supervision, such as medications for attention-deficit hyperactivity disorder or narcolepsy. Specify if:
Specify if:
Specify current severity:
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References
9.-Stimulant Intoxication
Synonyms and keywords:
Differential Diagnosis
- Anxiety disorder
- Bipolar disorder
- Depressive disorder
- Psychotic disorder
- Stimulant intoxication delirium
- Schizophrenia
- Stimulant-induced depressive disorder
- Generalized anxiety disorder
- Panic disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of stimulant intoxication is unknown of the overall population.[1]
Risk Factors
- High chronicity of use
- Low tolerance
- High rate of absortion[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic factors include:
- Convulsions
- Cardiac arrhythmia
- Hyperpyrexia
- Impaired social or occupational functioning[1]
Diagnostic Criteria
DSM-V Diagnostic for Stimulant Intoxication[1]
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A. Recent use of an amphetamine-type substance, cocaine, or other stimulant. AND B. Clinically significant problematic behavioral or psychological changes (e.g., euphoria or affective blunting: changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment) that developed during, or shortly after, use of a stimulant. AND C. Two (or more) of the following signs or symptoms, developing during, or shortly after, stimulant use:
AND D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance. Specify the specific intoxicant (i.e., amphetamine-type substance, cocaine, or other stimulant). Specify if:
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References
10.- Stimulant Withdrawal
Synonyms and keywords:
Differential Diagnosis
- Anxiety disorder
- Bipolar disorder
- Depressive disorder
- Psychotic disorder
- Sexual dysfunction
- Sleep disorder
- Stimulant-induced intoxication delirium[1]
Epidemiology and Demographics
Prevalence
The prevalence of stimulant withdrawal is unknown of the overall population.[1]
Risk Factors
Repetitive high-dose use[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
Diagnostic Criteria
- A. Cessation of (or reduction in) prolonged amphetamine-type substance, cocaine, or other stimulant use.
AND
- B. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A:
- Fatigue.
- Vivid, unpleasant dreams.
- Insomnia or hypersomnia.
- Increased appetite.
- Psychomotor retardation or agitation.
AND
- C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
AND
- D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
Specify the specific substance that causes the withdrawal syndrome (i.e., amphetamine-type substance, cocaine, or other stimulant).
References
11.- Somatic Symptom Disorder
Synonyms and keywords: Somatoform disorder
Differential Diagnosis
- Anxiety disorder
- Body dysmorphic disorder
- Diabetes
- Heart disease
- Irritable bowel syndrome
- Fibromyalgia
- Panic disorder
- Obsessive-compulssive disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of somatic symptom disorder is 5,000 to 7,000 per 100,000 (5-7%) of the overall population.[1]
Risk Factors
- Negative affectivity (neuroticism)
- Comorbid anxiety
- Depression
- Few years of education
- Lower socioeconomic status
- History of sexual abuse[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
- Depression
- Anxiety
- Persistent depressive disorder (dysthymia)
- Panic disorder
- Social stress
- Illness benefits
- Cognitive factors that affect clinical course include sensitization to pain, heightened attention to bodily sensations, and attribution of bodily symptoms to a possible medical[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Somatic Symptom Disorder[1]
A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
AND
B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
- Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
- Persistently high level of anxiety about health or symptoms.
- Excessive time and energy devoted to these symptoms or health concerns.
AND
C. Although anyone somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).
Specify if:
- With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.
Specify if:
- Persistent: A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).
Specify current severity:
- Mild: Only one of the symptoms specified in Criterion B is fulfilled.
- Moderate: Two or more of the symptoms specified in Criterion B are fulfilled.
- Severe: Two or more of the symptoms specified in Criterion B are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom).
References
12.- Illness Anxiety Disorder
Synonyms and keywords: Hypochondriasis
Differential Diagnosis
- Persistent health-related anxiety
- Anxiety disorder
- Obsessive-compulsive disorder
- Major depressive disorder
- Schizophrenia
- Delusional disorder
- Major depressive disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of illness anxiety disorder is 1,300 to 10,000 per 100,000 (1.3% to 10%) of the overall population.[1]
Risk Factors
- History of childhood abuse
- Serious childhood illness[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
- Decrement in physical function
- Damage to occupational performance
- History of sexual abuse[1]
Diagnostic Criteria
A. Preoccupation with having or acquiring a serious illness.
AND
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.
AND
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
AND
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
AND
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.
AND
F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.
Specify whether:
- Care-seeking type: Medical care, including physician visits or undergoing tests and procedures, is frequently used.
- Care-avoidant type: Medical care is rarely used.
References
13.- Exhibitionistic Disorder
Synonyms and keywords: Exhibitionism
Differential Diagnosis
- Conduct disorder
- Antisocial personality disorder
- Substance use disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of exhibitionistic disorder is 2,000 to 4,000 per 100,000 (2% to 4%) of the overall male population.[1]
Risk Factors
- Antisocial history
- Antisocial personality disorder
- Alcohol misuse
- Male gender
- Pedophilic sexual preference[1]
Natural History, Complications and Prognosis
Prognosis
Poor prognostic factors include:
- Alcohol misuse
- Antisocial personality disorder
- History of childhood emotional or sexual abuse[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Paranoid Personality Disorder[1]
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AND
Specify whether:
Specify if;
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References
13.-Frotteuristic Disorder
Synonyms and keywords: Frotteurism; frotteuristic disorder
Differential Diagnosis
- Antisocial personality disorder
- Conduct disorder
- Substance use disorders[1]
Epidemiology and Demographics
Prevalence
The prevalence of frotteuristic disorder is up to 30% adult males in the general population.[1]
Risk Factors
- Nonsexual antisocial behavior
- Sexual preoccupation/hypersexuality[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
- "Recurrent" touching or rubbing against a nonconsenting individual
- Subjective distress (e.g., guilt, shame, intense sexual frustration, loneliness)
- Psychiatric morbidity
- Hypersexuality and sexual impulsivity
- Psychosocial impairment[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Frotteuristic Disorder[1]
- A. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.
AND
- B. The individual has acted on these sexual urges with a non consenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
- In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to touch or rub against a non consenting person are restricted.
- In full remission: The individual has not acted on the urges with a nonconsenting per son, and there has been no distress or impairment in social, occupational, or other areas of functioning, for at least 5 years while in an uncontrolled environment.
References
15.-Avoidant/Restrictive Food Intake Disorder
Synonyms and keywords:
Differential Diagnosis
- Gastrointestinal disease
- Food allergies and intolerances
- Occult malignancies
- Specific neurological/neuromuscular
- Structural, or congenital disorders
- Conditions associated with feeding difficulties
- Reactive attachment disorder
- Autism spectrum disorder
- Specific phobia
- Social anxiety disorder (social phobia)
- Anorexia nervosa
- Obsessive-compulsive disorder
- Major depressive disorder
- Schizophrenia spectrum disorders
- Factitious disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of Avoidant/Restrictive Food Intake Disorder is unknown of the overall population.[1]
Risk Factors
- Anxiety disorder
- Autism spectrum disorder
- Attention-deficit/hyperactivity disorder
- Gastroesophageal reflux disease
- History of gastrointestinal conditions
- Obsessive-compulsive disorder
- Vomiting[1]
Natural History, Complications and Prognosis
Prognosis
- Apparent lack of interest in eating or food
- Concern about aversive consequences of eating
- Persistent failure to meet appropriate nutritional and/or energy needs[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Paranoid Personality Disorder[1]
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A. An eating or feeding disturbance (e.g. apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
B. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice. C. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced. D. The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention. Specify if: In remission: After full criteria for avoidant/restrictive food intake disorder were previously met, the criteria have not been met for a sustained period of time. |
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