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: Sonya Gelfand, Kiran Singh, M.D. [2]

Overview

According to the DSM-V, substance/medication-induced obsessive-compulsive or related disorder is diagnosed in patients with obsessions and compulsions characteristic of OCD, but that develop during or after substance intoxication or withdrawal or after exposure to medications.

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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