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JI Randolph Patrick P. Mayaco II
JI Randolph Patrick P. Mayaco II
JI Randolph Patrick P. Mayaco II

JI Randolph Patrick P. Mayaco II

Signs and Symptoms General Medical Condition Substance
Signs and Symptoms
General Medical Condition
Substance

Mood Disorder

Depressed
Depressed
Manic
Manic
Signs and Symptoms General Medical Condition Substance Mood Disorder Depressed Manic PSYCHOTIC DISORDER
Signs and Symptoms General Medical Condition Substance Mood Disorder Depressed Manic PSYCHOTIC DISORDER

PSYCHOTIC DISORDER

CONDITION
CONDITION

DIFFERENTIAL DIAGNOSIS OF

MENTAL DISORDERS DUE TO A

GENERAL MEDICAL

Symptoms that are due to the direct effects of a general medical condition
Symptoms that are due to the direct effects of a general medical condition
Symptoms that
are due to the
direct effects of a
general medical
condition
Disturbances of consciousness and a change in cognition No Yes Evidence that the disturbance has more

Disturbances of consciousness and a change in cognition

No

Yes

Disturbances of consciousness and a change in cognition No Yes Evidence that the disturbance has more

Evidence that the

disturbance has more than one etiology

No

Disturbances of consciousness and a change in cognition No Yes Evidence that the disturbance has more
Yes
Yes

DELIRIUM DUE TO A GENERAL MEDICAL CONDITION

DELIRIUM DUE TO MULTIPLE ETIOLOGIES

Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

Yes

At least 1 additional cognitive deficit
At least 1
additional
cognitive
deficit
Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

No

Evidence that the disturbance

has more than 1 etiology

Yes

Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

Yes

Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1
Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

No

Evidence that

cerebrovascular disease is etiologicially related to

the disturbance

Yes

Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

DEMENTIA

DUE TO MULTIPLE ETIOLOGI ES

Memory

impairment

Yes At least 1 additional cognitive deficit No Evidence that the disturbance has more than 1

AMNESTIC

DISORDER

DUE TO A

GENERAL

MEDICAL

VASCULAR

DEMENTIA

CONDITION

No

Yes Disrturbance due to central nervous system condition or systemic condition known to cause dementia
  • Yes

Disrturbance due to central nervous system condition or systemic condition known to cause dementia

  • No

Gradual onset and continuing cognitive decline

Yes Disrturbance due to central nervous system condition or systemic condition known to cause dementia

Yes

Yes Disrturbance due to central nervous system condition or systemic condition known to cause dementia
No
No

DEMENTIA DUE TO A GENERAL MEDICAL CONDITION

DEMENTIA OF THE

ALZHEIMER’S TYPE

DEMENTIA NOS

Prominent delusions of hallucinations predominate Yes No Prominent and prevalent mood disturbances predominates Yes No PSYCHOTIC

Prominent delusions of hallucinations predominate

Yes

Prominent delusions of hallucinations predominate Yes No Prominent and prevalent mood disturbances predominates Yes No PSYCHOTIC

No

Prominent and prevalent

mood disturbances predominates

Yes

Prominent delusions of hallucinations predominate Yes No Prominent and prevalent mood disturbances predominates Yes No PSYCHOTIC

No

PSYCHOTIC

DISORDER DUE TO A GENERAL MEDICAL CONDITION

MOOD DISORDER DUE TO A GENERAL MEDICAL CONDITION

Prominent anxiety, panic attacks, depressions, or compulsions predominate

Yes

Prominent delusions of hallucinations predominate Yes No Prominent and prevalent mood disturbances predominates Yes No PSYCHOTIC

No

ANXIETY DISORDER DUE TO A GENERAL MEDICAL CONDITION

Clinically significant sexual dysfunction exclusively due to a general medical condition Yes SEXUAL DYSFUNCTION DUE TO
Clinically significant
sexual dysfunction
exclusively due to a
general medical condition
Yes
SEXUAL
DYSFUNCTION DUE
TO A GENERAL
MEDICAL
CONDITION
No
Disturbance in sleep
sufficiently severe to
warrant independent
clinical attention
Yes
SLEEP DISORDER
DUE TO A GENERAL
MEDICAL
CONDITION
No
CATATONIC
Catatonia
Yes
No
DISORDER DUE TO
A GENERAL
MEDICAL
CONDITION
PERSONALITY Yes CHANGE DUE TO A GENERAL MEDICAL CONDITION No
PERSONALITY
Yes
CHANGE DUE TO A
GENERAL MEDICAL
CONDITION
No

Change in previous

personality pattern

Clinically significant

symptoms etiologicallly

related to a general medical condition that do not meet criteria for a specific Mental Disorder Due to a General Medical Condition

MENTAL DISORDER

NOS DUE TO A GENERAL MEDICAL CONDITION

Yes

PERSONALITY Yes CHANGE DUE TO A GENERAL MEDICAL CONDITION No Change in previous personality pattern Clinically
No No mental disorder
No
No mental disorder
DIFFERENTIAL DIAGNOSIS OF SUBSTANCE-INDUCED DISORDERS

DIFFERENTIAL DIAGNOSIS OF

SUBSTANCE-INDUCED

DISORDERS

Symptoms that are due to the direct physiological effects of a substance
Symptoms that are due to the direct physiological effects of a substance
Symptoms that are due to the direct physiological effects of a substance
Symptoms that are due to the direct physiological effects of a substance
Symptoms that are
due to the direct
physiological
effects of a
substance
A disturbance of consciousness & a change in cognition that are SUBSTAN Onset of CE- Yes
A disturbance of consciousness & a change in cognition that are SUBSTAN Onset of CE- Yes
A disturbance of consciousness & a change in cognition that are SUBSTAN Onset of CE- Yes
A disturbance of consciousness & a change in cognition that are SUBSTAN Onset of CE- Yes
A disturbance of
consciousness & a
change in
cognition that are
SUBSTAN
Onset of
CE-
Yes
No
in excess of that
usually seen in
Evidence that the
disturbance has
more than 1
etiology
delirium
during
withdrawal
from a
substance
INDUCED
Yes
WITHDR
AWAL
DELIRIU
intoxication/
M
withdrawal & that
warrant
independent
clinical attention
No
SUBSTANCE-
INDUCED
INTOXICATION
Yes
DELIRIUM
No
DELIRIUM DUE TO
MULTIPLE
ETIOLOGIES
SUBSTANCE At least 1 additional cognitive deficit -INDUCED Persistent PERSISTIN memory Evidence that the disturbance has
SUBSTANCE At least 1 additional cognitive deficit -INDUCED Persistent PERSISTIN memory Evidence that the disturbance has
SUBSTANCE At least 1 additional cognitive deficit -INDUCED Persistent PERSISTIN memory Evidence that the disturbance has
SUBSTANCE At least 1 additional cognitive deficit -INDUCED Persistent PERSISTIN memory Evidence that the disturbance has
SUBSTANCE
At least 1
additional
cognitive
deficit
-INDUCED
Persistent
PERSISTIN
memory
Evidence that
the disturbance
has >1 etiology
G
impairment
Yes
Yes
No
DEMENTIA
No
Yes
DEMENTIA DUE TO
MULTIPLE
No
ETIOLOGIES

SUBSTANCE-INDUCED PERSISTING AMNESTIC DISORDER

Delusions or hallucinations predominate, are in excess of that usually seen in intoxication or withdrawal, and
Delusions or hallucinations predominate, are in excess of that usually seen in intoxication or withdrawal, and
Delusions or hallucinations predominate, are in excess of that usually seen in intoxication or withdrawal, and

Delusions or hallucinations predominate, are in excess of that usually seen in intoxication or withdrawal, and warrant independent clinical attention

Yes
Yes

No

SUBSTANCE-INDUCED

PSYCHOTIC DISORDER

A mood disturbance predominates, is in excess of that usually seen in intoxication or withdrawal, and
A mood disturbance predominates, is in excess of that usually seen in intoxication or withdrawal, and
A mood disturbance predominates, is in excess of that usually seen in intoxication or withdrawal, and

A mood disturbance predominates, is in excess of that usually seen in intoxication or withdrawal, and warrants independent clinical attention

No

Yes
Yes

SUBSTANCE-INDUCED

MOOD DISORDER

Anxiety, panic attacks, or obsessions or compulsions predominate; are in excess of that usually seen in
Anxiety, panic attacks, or obsessions or compulsions predominate; are in excess of that usually seen in
Anxiety, panic attacks, or obsessions or compulsions predominate; are in excess of that usually seen in

Anxiety, panic attacks, or obsessions or compulsions predominate; are in excess of that usually seen in intoxication or withdrawal; and warrant independent clinical attention

Yes
Yes

No

SUBSTANCE-INDUCED

ANXIETY DISORDER

Clinically significant sexual dysfunction exclusively due to a substance, is in excess of that usually seen
Clinically significant sexual dysfunction exclusively due to a substance, is in excess of that usually seen
Clinically significant sexual dysfunction exclusively due to a substance, is in excess of that usually seen
Clinically significant sexual dysfunction exclusively due to a substance, is in excess of that usually seen

Clinically significant sexual dysfunction exclusively due to a substance, is in excess of that usually seen in intoxication, and warrants independent clinical attention

No

Yes
Yes

SUBSTANCE-INDUCED

SEXUAL DYSFUNCTION

Disturbance in sleep that is sufficiently severe to warrant independent clinical attention and is in excess
Disturbance in sleep that is sufficiently severe to warrant independent clinical attention and is in excess
Disturbance in sleep that is sufficiently severe to warrant independent clinical attention and is in excess

Disturbance in sleep that is sufficiently severe to warrant independent clinical attention and is in excess of that usually seen in intoxication or withdrawal

Disturbance in sleep that is sufficiently severe to warrant independent clinical attention and is in excess

Yes

No

SUBSTANCE-INDUCED

SLEEP DISORDER

Development of a reversible syndrome due to recent use of a substance Yes No SUBSTANCE INTOXICATION
Development of a reversible syndrome due to recent use of a substance Yes No SUBSTANCE INTOXICATION
Development of a reversible syndrome due to recent use of a substance Yes No SUBSTANCE INTOXICATION

Development of a reversible syndrome due to recent use of a substance

Yes

Development of a reversible syndrome due to recent use of a substance Yes No SUBSTANCE INTOXICATION

No

SUBSTANCE

INTOXICATION

Development of a syndrome due to reduction or cessation of use of a substance

Development of a reversible syndrome due to recent use of a substance Yes No SUBSTANCE INTOXICATION

Yes

No

SUBSTANCE

WITHDRAWAL

Clinically significant symptoms due to substance that do not meet criteria for one of the Substance-Induced
Clinically significant symptoms due to substance that do not meet criteria for one of the Substance-Induced
Clinically significant symptoms due to substance that do not meet criteria for one of the Substance-Induced

Clinically significant symptoms due to substance that do not meet criteria for one of the Substance-Induced Disorders

SUBSTANCE-

RELATED DISORDER

NOS

Yes

Clinically significant symptoms due to substance that do not meet criteria for one of the Substance-Induced
No No Substance-Induced Disorder
No
No Substance-Induced Disorder
DIFFERENTIAL DIAGNOSIS OF MOOD DISORDERS
DIFFERENTIAL DIAGNOSIS OF
MOOD DISORDERS
Depressed, elevated, expansive, or irritable mood
Depressed, elevated, expansive, or irritable mood
Depressed,
elevated,
expansive, or
irritable mood
Due to the direct physiological effects of a general medical condition Yes MOOD DISORDER DUE TO

Due to the direct physiological effects of a general medical condition

Yes

Due to the direct physiological effects of a general medical condition Yes MOOD DISORDER DUE TO

MOOD DISORDER DUE TO A GENERAL MEDICAL CONDITION

No

Due the direct physiological effects of a substance

Yes

Due to the direct physiological effects of a general medical condition Yes MOOD DISORDER DUE TO

No

Determine type of present and past mood disorders

No

SUBSTANCE-

INDUCED MOOD DISORDER

Elevated, expansive, or irritable mood, at least 1 week duration; marked impairment or hospitalization Yes MANIC
Elevated, expansive, or irritable mood, at least 1 week duration; marked impairment or hospitalization Yes MANIC
Elevated, expansive, or
irritable mood, at least 1 week
duration; marked impairment
or hospitalization
Yes
MANIC EPISODE
No
Elevated, expansive, or irritable
mood, at least 4-day duration;
changes observable by others
but less severe than a Manic
Episode
HYPOMANIC
EPISODE
Yes
No
At least 2 weeks of depressed mood or loss of interest plus associated symptoms, and not
At least 2 weeks of depressed mood or loss of interest plus associated symptoms, and not

At least 2 weeks of depressed mood or loss of interest plus associated symptoms, and not better accounted for by Bereavement

No

Criteria met for Manic Episode and Major Depressive Episode nearly everyday for at least 1 week

No

MAJOR

DEPRESSIVE

EPISODE

Yes

At least 2 weeks of depressed mood or loss of interest plus associated symptoms, and not

MIXED EPISODE

Yes

At least 2 weeks of depressed mood or loss of interest plus associated symptoms, and not
Has never had a MANIC EPISODE or a MIXED EPISODE Psychotic symptoms occur at times other
Has never had a MANIC EPISODE or a MIXED EPISODE Psychotic symptoms occur at times other

Has never had a MANIC EPISODE or a MIXED EPISODE

Psychotic symptoms

occur at times other than during Manic or Mixed Episode

Yes

Yes

Has never had a MANIC EPISODE or a MIXED EPISODE Psychotic symptoms occur at times other

No

Has never had a MANIC EPISODE or a MIXED EPISODE Psychotic symptoms occur at times other

No

BIPOLAR I DISORDER

Occurred exclusively during Schizoaffective Disorder

Yes
Yes

No

SCHIZOAFFECTIVE DISORDER, BIPOLAR TYPE

BIPOLAR DISORDER NOS

Has never had a HYPOMANIC EPISODE and at least 1 MAJOR DEPRESSIVE EPISODE Yes No 2+
Has never had a HYPOMANIC EPISODE and at least 1 MAJOR DEPRESSIVE EPISODE Yes No
Has never had a HYPOMANIC
EPISODE and at least 1 MAJOR
DEPRESSIVE EPISODE
Yes
No

2+ years of hypomanic symptoms and periods of depressed mood

Has never had a HYPOMANIC EPISODE and at least 1 MAJOR DEPRESSIVE EPISODE Yes No 2+

Yes

BIPOLAR II DISORDER

CYCLOTHYMIC

DISORDER

No

Clinically significant manic/hypomanic symptoms that do not meet criteria for a specific Bipolar Disorder Yes No

Clinically significant manic/hypomanic symptoms that do

not meet criteria for a specific Bipolar

Disorder

Yes

Clinically significant manic/hypomanic symptoms that do not meet criteria for a specific Bipolar Disorder Yes No

No

BIPOLAR

DISORDER NOS

Has never had a MAJOR DEPRESSIVE EPISODE Psychotic symptoms occur at times other than during Major

Has never had a MAJOR DEPRESSIVE EPISODE

Psychotic symptoms occur at times other than during Major Depressive Episodes

Yes

Yes

Has never had a MAJOR DEPRESSIVE EPISODE Psychotic symptoms occur at times other than during Major

No

Has never had a MAJOR DEPRESSIVE EPISODE Psychotic symptoms occur at times other than during Major

No

Occurred exclusively

during Schizoaffective

Disorder

Yes
Yes

No

MAJOR

DEPRESSIVE

DISORDER

SCHIZOAFFECTI VE DISORDER, DEPRESSIVE TYPE

DEPRESSIVE DISORDER NOS

Depressed mood, more days than not, for at least 2 years with associated symptoms No Depressed

Depressed mood, more days than not, for at least 2 years with associated symptoms

No

Depressed mood not meeting criteria

for one of above Mood Disorders that

develops in response to a stressor

Yes

Depressed mood, more days than not, for at least 2 years with associated symptoms No Depressed

Yes

Depressed mood, more days than not, for at least 2 years with associated symptoms No Depressed

DYSTHYMIC DISORDER

ADJUSTMENT DISORDER WITH DEPRESSED MOOD

No

Clinically significant depressive symptoms that do not meet criteria for a specific Mood Disorder DEPRESSIVE DISORDER

Clinically significant depressive symptoms that do not meet criteria for a specific Mood Disorder

DEPRESSIVE DISORDER NOS

Clinically significant depressive symptoms that do not meet criteria for a specific Mood Disorder DEPRESSIVE DISORDER

Yes

No No Mood Disorder
No
No Mood Disorder

DIFFERENTIAL DIAGNOSIS OF

PSYCHOTIC

DISORDERS

Delusions, hallucinations, disorganized speech, or grossly disorganized behavior
Delusions, hallucinations, disorganized speech, or grossly disorganized behavior
Delusions,
hallucinations,
disorganized
speech, or grossly
disorganized
behavior
Due to the direct physiological effect of a general medical condition Yes No Due to the

Due to the direct physiological effect of a general medical condition

Yes

Due to the direct physiological effect of a general medical condition Yes No Due to the

No

Due to the direct physiological effects of a substance

Yes

Due to the direct physiological effect of a general medical condition Yes No Due to the

PSYCHOTIC DISORDER DUE TO A GENERAL

MEDICAL CONDITION

SUBSTANCE-

INDUCED

PSYCHOTIC

DISORDER

No

Symptoms of active phase of Schizophrenia, lasting for at least 1 month No Major Depressive or

Symptoms of active phase of Schizophrenia, lasting for at least 1 month

No

Major Depressive or Manic Episode concurrent with active-

phase symptoms

Yes

Yes

Symptoms of active phase of Schizophrenia, lasting for at least 1 month No Major Depressive or

No

Total duration of mood episodes has

been brief relative

to duration of

active and residual periods

Duration of at least 6 months

No
No

SCHIZOPHRE

NIA

Yes

Symptoms of active phase of Schizophrenia, lasting for at least 1 month No Major Depressive or

SCHIZOPHRENIFORM

DISORDER

At least 2 weeks of delusions or hallucinations in the absence of prominent mood symptoms Yes

At least 2 weeks of delusions or hallucinations in the

absence of prominent

mood symptoms

Yes No
Yes
No

SCHIZOAFFECTIVE

DISORDER

MOOD DISORDER WITH PSYCHOTIC FEATURES

Yes Yes Yes Apart from disturbances, functioning not markedly impaired DELUSIONA Nonbizarre delusions lasting at least
Yes Yes Yes Apart from disturbances, functioning not markedly impaired DELUSIONA Nonbizarre delusions lasting at least
Yes
Yes
Yes
Apart from
disturbances,
functioning not
markedly
impaired
DELUSIONA
Nonbizarre
delusions lasting
at least 1 month
Total duration
of mood
episodes has
been brief
relative to
L
DISORDER
duration of
delusional
periods
No
PSYCHOTIC
DISORDER
No
Delusions occur
only during mood
episodes
NOS
No
Yes
MOOD DISORDER WITH
PSYCHOTIC FEATURES
Duration more than 1 day but less than 1 month Yes No BRIEF PSYCHOTIC DISORDER PSYCHOTIC

Duration more than 1 day but less than 1 month

Yes No
Yes
No

BRIEF PSYCHOTIC DISORDER

PSYCHOTIC

DISORDER NOS

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