Substance-induced psychiatric disorders, defined in the DSM-5-TR as "substance-/medication-induced mental disorders," are psychiatric changes produced by substance use or withdrawal that resemble independent psychiatric disorders (eg, depression, psychosis, anxiety, or neurocognitive disorders) (1–3).
For a psychiatric disorder to be considered substance-induced, the substance involved must be known to be capable of causing the disorder. Substances can belong to the 10 drug classes that typically cause substance-related disorders (see table Ten Drug Classes Commonly Associated With Substance-Related Disorders) or many other drug classes (eg, anticholinergics and glucocorticoids may cause temporary psychotic syndromes). In general, the psychiatric disorder should meet the following criteria (4):
Appear within 1 month of substance intoxication or withdrawal
Cause significant distress or impaired functioning
Not have manifested before use of the substance
Not occur solely during acute delirium caused by the substance
Not persist for a substantial period of time*
* Certain neurocognitive disorders caused by alcohol, inhalants, or sedative-hypnotics and perceptual disorders caused by hallucinogens may be long-lasting.
Specific diagnosable substance-induced psychiatric disorders include the following (4):
Substance-/Medication-induced psychotic disorders
Substance-/Medication-induced bipolar and related disorders
Substance-/Medication-induced depressive disorders
Substance-/Medication-induced anxiety disorders
Substance-/Medication-induced obsessive-compulsive and related disorders
Substance-/Medication-induced sleep disorders
Substance-/Medication-induced sexual dysfunction (see Female Sexual Function and Dysfunction and Male Sexual Function and Dysfunction)
Substance-/Medication-induced major or mild neurocognitive disorder
References
1. Tucker JS, Huang W, Green HD Jr, Pollard MS. Patterns of Substance Use and Associations with Mental, Physical, and Social Functioning: A Latent Class Analysis of a National Sample of U.S. Adults Ages 30-80. Subst Use Misuse. 2021;56(1):131-139. doi:10.1080/10826084.2020.1843059
2. Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P. Substance-Induced Psychoses: An Updated Literature Review. Front Psychiatry. 2021;12:694863. Published 2021 Dec 23. doi:10.3389/fpsyt.2021.694863
3. Melugin PR, Nolan SO, Siciliano CA. Bidirectional causality between addiction and cognitive deficits. Int Rev Neurobiol. 2021;157:371-407. doi:10.1016/bs.irn.2020.11.001
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition, Text Revision. American Psychiatric Association Publishing; 2022:543-553.
