The diagnosis of substance/medication-induced psychotic disorder is characterized by delusions and/or hallucinations that are believed to be brought on due to the physiological effects of a substance and/or medication(s). Delusions and/or hallucinations that the individual understands to be substance/medication-induced do not meet the criteria for diagnosis.

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A. Presence of Delusions and/or Hallucinations.

B. There is evidence from the history, physical examination, or laboratory findings of both:

1. The symptoms in Criterion A developed during or soon after substance
intoxication or withdrawal or after exposure to or withdrawal from a
medication.
2. The involved substance/medication is capable of producing the symptoms in Criterion A.

C. The disturbance is not better explained by a psychotic disorder that is not substance/medication-induced. 

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

E. The disturbance causes clinically significant distress or impairment in social, occupational, 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.

[DSM-5-TR] Diagnostic Criteria of Substance/Medication-Induced Psychotic Disorder

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

The DSM-5-TR outlines a few specifiers to help specify the condition of Substance / Medication-Induced Psychotic Disorder according to the different substances and state of the substance affecting the individual. The following chart lists out the applicable substances and states that may be coded.

The ICD-10-CM codes for the [specific substance/medication]-induced psychotic disorders are indicated in this table.

The specifiers that may be applied to the diagnosis are as followed:
- With Onset During Intoxication
- With Onset During Withdrawal
- With Onset After Medication Use

[DSM-5-TR] Specifiers for Substance/Medication-Induced Psychotic Disorder

The name of the substance/medication-induced psychotic disorder begins with the specific substance (e.g., cocaine, dexamethasone) that is presumed to be causing the delusions or hallucinations. The diagnostic code is based on the drug class and presence or absence of a comorbid substance use disorder. For substances that do not fit into any of the classes (e.g., dexamethasone), the code for “other (or unknown) substance” should be used; and in cases in which a substance is judged to be an etiological factor but the specific class of substance is unknown, the same code should also be used.

When recording the name of the disorder, the comorbid substance use disorder (if any) is listed first, followed by the word “with,” followed by the name of the substance-induced psychotic disorder, followed by the specification of onset (i.e., onset during intoxication, onset
during withdrawal). 

For example, in the case of delusions occurring during intoxication in a man with a severe cocaine use disorder, the diagnosis is F14.259 severe cocaine use disorder with cocaine-induced psychotic disorder, with onset during intoxication. A separate diagnosis of the comorbid severe cocaine use disorder is not given. 

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