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 suggesting the existence of an independent non-substance/medication-induced depressive disorder (e.g., a his- tory 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 instead of a diagnosis of substance intoxication or substance withdrawal only when the symptoms in Criterion A predominate in the clinical picture and when they are sufficiently severe to warrant clinical attention.
Coding note: The |CD-9-CM and |CD-10-CM codes for the [specific substance/medica- tion]-induced depressive 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 depressive disorder, the 4th position character is “1 and the clinician should record “mild [substance] use disordef’ before the substance-induced depressive disorder (e.g., “mild cocaine use disorder with cocaine-induced depressive disorder”). It a moderate or se- vere substance use disorder is comorbid with the substance-induced depressive 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 depressive disorder.
With use disorder, Without disorder, moderate use
Alcohol 291.89 F1014 F1024 F10.94
Phencyclidine 292.84 F1614 F1624 F1694
Other hallucinogen 292.84 F1614 F1624 F1694
Inhalant 292.84 F1814 F1824 F1894
Opioid 292.84 F11.14 F1124 F1194
Sedative, hypnotic, or anxiolytic 292.84 F13.14 F1324 F1394
Amphetamine (or other 292.84 F1514 F1524 F1594
Cocaine 292.84 F14.14 F1424 F1494
Other (or unknown) substance 292.84 F1914 F1924 F1994
Specify it (see Table 1 in the chapter “Substance-Related and Addictive Disorders" tor di- agnoses associated with substance class):
With onset during intoxication: If criteria are met for intoxication with the substance and the symptoms develop during intoxication.
With onset during withdrawal: If criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.