Substance/Medication-Induced Psychotic Disorder

Criterion A

Presence of one or both of the following symptoms:

  1. Delusions
  2. Hallucinations
Criterion 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
Criterion 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 in clude 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 recur rent non-substance/medication-related episodes).
Criterion D

The disturbance does not occur exclusively during the course of a delirium.

Criterion E

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Common substances include alcohol, amphetamines, cannabis, cocaine, hallucinogens, opioids, phencyclidine (PCP), and sedative/hypnotics.

In individuals diagnosed with a substance-induced psychosis (SIP), predictors of conversion to schizophrenia include male sex, early age at first diagnosis, additional SIP diagnoses, initial hospitalization, longer hospitalizations, and most importantly, a family history of non-affective psychosis. This suggests that familial vulnerability for psychosis greatly increases the risk for later schizophrenia.[1]

A variety of medications can cause medication-induced psychosis, including: steroids, interferon therapy, and mefloquine.[2]