A. Obsessions, compulsions. skin picking, hair pulling, other body-tocused repetitive be- haviors, or other symptoms characteristic of the obsessive-compulsive and related dis- orders predominate in the clinical picture.
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 Crite- rion A.
C. The disturbance is not better explained by an obsessive-compulsive and related disor- der that is not substance/medication-induced. Such evidence of an independent ob- sessive-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 exis- tence of an independent non-substance/medication-induced obsessive-compul- sive and related disorder (e.g., a history of recurrent non-substance/medication- related episodes).
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social, occupa- tional, 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.
Coding note: The lCD-Q-CM and ICD-10-CM codes for the [specific substance/medica- tion]-induced obsessive-compulsive and related disorders are indicated in the table below.
Note that the |CD-10-CM code depends on whether or not there is a comorbid substance use disorder present for the same class of substance. If a mild substance use disorder is comorbid with the substance-induced obsessive-compulsive and related disorder, the 4th position character is “1’ and the clinician should record “mild [substance] use disorder" before the substance-induced obsessive-compulsive and related disorder (e.g., “mild co- caine use disorder with cocaine-induced obsessive-compulsive and related disorder"). It a moderate or severe substance use disorder is comorbid with the substance-induced ob- sessive-compulsive and related disorder, the 4th position character is ‘,"2 and the clinician should record “moderate [substance] use disorder” or “severe [substance] Use disorder," depending on the severity of the comorbid substance use disorder. If there is no comorbid substance use disorder (e.g., after a one—time heavy use of the substance), then the 4th position character is “9,” and the clinician should record only the substance-induced ob- sessive-oompulsive and related disorder.
With use disorder, Without disorder, moderate use
Amphetamine (or other 292.89 F15.188 F15.288 F15.988
Cocaine 292.89 F14.188 Fl 4.288 F14.988
Other (or unknown) substance 292.89 F19.188 F19.288 F19.988
Specify it (see Table 1 in the chapter “Su bstance-Related and Addictive Disorders” for di- agnoses associated with substance class):
With onset during intoxication: If the criteria are met for intoxication with the sub- stance and the symptoms develop during intoxication.