DSM-III

This section permits the identification of specific Organic Brain Syndromes associated with physical disorders. Examples would include Delirium associated with pneumonia and Dementia associated with brain tumor.

DSM-IV

Disorders

  1. Delirium Due to a General Medical Condition
  2. Dementia Due to a General Medical Condition
  3. Amnestic Disorder Due to a General Medical Condition
  4. Psychotic Disorder Due to a General Medical Condition
  5. Mood Disorder Due to a General Medical Condition
  6. Anxiety Disorder Due to a General Medical Condition
  7. Sexual Dysfunction Due to a General Medical Condition
  8. Sleep Disorder Due to a General Medical Condition
  9. Catatonic Disorder Due to General Medical Condition
  10. Personality Change Due to General Medical Condition
  11. Mental Disorder NOS Due to General Medical Condition

Recording Procedures

In recording a Mental Disorder Due to a General Medical Condition, the clinician should note both the type of mental disturbance and the etiological general medical condition (e.g., Mood Disorder Due to Hypothyroidism, With Depressive Features). The general medical condition (e.g., hypothyroidism) should also be noted. In situations in which the clinician has determined that the mental symptoms are not a direct physiological consequence of the general medical condition, the primary mental disorder should be recorded and the general medical condition should be recorded.

Differential Diagnosis

Primary mental disorder

A Mental Disorder Due to a General Medical Condition is distinguished from a primary mental disorder by applying the diagnostic criteria. When symptoms of a mental disorder and a general medical condition co-occur, it is especially important to determine whether the etiological relationship, if any, is directly physiological (in which case the diagnosis is Mental Disorder Due to a General Medical Condition) or through another mechanism (in which case the diagnosis is a primary mental disorder). In some cases, the development of a general medical condition or the presence of associated disability may precipitate or exacerbate a mental disorder, with no known physiological link (e.g., the disability associated with osteoarthritis may play a role in the development of depressive symptoms or a Major Depressive Episode, but there is no known physiological mechanism underlying the etiological relationship between the arthritis and the depressive symptoms). In this situation, the primary mental disorder (i.e., Adjustment Disorder or Major Depressive Disorder) should be diagnosed and the general medical condition (i.e., osteoarthritis) should be listed.

Substance-Induced Disorder

A Mental Disorder Due to a General Medical Condition must also be distinguished from a Substance-Induced Disorder. If there is evidence of recent or prolonged use of a substance (including medications with psychoactive effects), withdrawal from a substance, or exposure to a toxin, a Substance-Induced Disorder should be considered. It may be useful to obtain a urine or blood drug screen or other appropriate laboratory evaluation. Symptoms that occur during or shortly after (i.e., within 4 weeks of) significant substance intoxication or withdrawal or medication use may be especially indicative of a Substance-Induced Disorder, depending on the type or the amount of the substance used or the duration of use.

Combined effects of a general medical condition and substance use

Delirium, dementia, psychotic, mood, anxiety, or sleep symptoms or a sexual dysfunction may be caused by the combined effects of a general medical condition and substance use (including medications). In such situations, both diagnoses (e.g., Mood Disorder Due to a General Medical Condition and Substance-Induced Mood Disorder) should be listed. If it is not possible to ascertain whether the mental symptoms are due to a general medical condition or are substance induced, the Not Otherwise Specified category may be used.

Not Otherwise Specified

When, as often happens, the presentation of a Mental Disorder Due to a General Medical Condition contains a mix of different symptoms (e.g., mood and anxiety), it is generally desirable to assign a single diagnosis based on which symptoms predominate in the clinical presentation. In some situations, it is not possible to determine whether the mental symptoms are primary, due to a general medical condition, or substance induced. The Not Otherwise Specified category should be used in such situations.

DSM-5

In DSM-5, these disorders are spread throughout different categories

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