JI Randolph Patrick P.

Mayaco II
 Signs and Symptoms

General Medical Condition

Substance

Depressed Mood Disorder Manic

PSYCHOTIC DISORDER
 DIFFERENTIAL DIAGNOSIS OF

MENTAL DISORDERS DUE TO A

GENERAL MEDICAL
CONDITION
 Symptoms that
are due to the
direct effects of a
general medical
condition
 Yes No
Disturbances of Evidence that the DELIRIUM
consciousness and a disturbance has DUE TO A
change in cognition more than one GENERAL
etiology MEDICAL
Yes CONDITION

No
DELIRIUM DUE TO
MULTIPLE
ETIOLOGIES
 Yes At least 1 Yes Yes
Memory additional Evidence that DEMENTIA
impairment cognitive the DUE TO
deficit disturbance MULTIPLE
has more than ETIOLOGI
1 etiology ES
No
No
AMNESTIC Evidence that
DISORDER cerebrovascular disease is Yes
DUE TO A etiologicially related to VASCULAR
GENERAL the disturbance DEMENTIA
MEDICAL
No
CONDITION
 Yes DEMENTIA DUE TO
Disrturbance due to central
A GENERAL
nervous system condition or
MEDICAL
systemic condition known
CONDITION
to cause dementia
No

Gradual onset and Yes

continuing cognitive DEMENTIA OF THE
decline ALZHEIMER’S TYPE

No

DEMENTIA NOS
 PSYCHOTIC
Prominent delusions of DISORDER DUE TO
hallucinations Yes A GENERAL
predominate MEDICAL
No CONDITION

Prominent and prevalent MOOD DISORDER

mood disturbances DUE TO A GENERAL
predominates Yes MEDICAL
No CONDITION

Prominent anxiety, panic ANXIETY DISORDER

attacks, depressions, or Yes DUE TO A GENERAL
compulsions predominate MEDICAL
CONDITION
No
 SEXUAL
Clinically significant
DYSFUNCTION DUE
sexual dysfunction
Yes TO A GENERAL
exclusively due to a
MEDICAL
general medical condition
No CONDITION

Disturbance in sleep SLEEP DISORDER

sufficiently severe to DUE TO A GENERAL
warrant independent Yes
MEDICAL
clinical attention CONDITION
No

CATATONIC
Catatonia Yes DISORDER DUE TO
A GENERAL
No MEDICAL
CONDITION
 PERSONALITY
Change in previous
Yes CHANGE DUE TO A
personality pattern GENERAL MEDICAL
CONDITION
No
Clinically significant
MENTAL DISORDER
symptoms etiologicallly
NOS DUE TO A
related to a general medical
GENERAL MEDICAL
condition that do not meet
CONDITION
criteria for a specific Mental Yes
Disorder Due to a General
Medical Condition

No

No mental disorder
 DIFFERENTIAL DIAGNOSIS OF

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

No
Yes DEMENTIA DUE TO
No MULTIPLE
ETIOLOGIES

SUBSTANCE-INDUCED PERSISTING
AMNESTIC DISORDER
Delusions or hallucinations predominate, are in
excess of that usually seen in intoxication or
withdrawal, and warrant independent clinical
attention Yes

No

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

Yes

No
SUBSTANCE-INDUCED
MOOD DISORDER
 Anxiety, panic attacks, or obsessions or
compulsions predominate; are in excess of
that usually seen in intoxication or
withdrawal; and warrant independent Yes
clinical attention

No
SUBSTANCE-INDUCED
ANXIETY DISORDER
 Clinically significant sexual dysfunction
exclusively due to a substance, is in excess
of that usually seen in intoxication, and
warrants independent clinical attention
Yes

No
SUBSTANCE-INDUCED
SEXUAL DYSFUNCTION
 Disturbance in sleep that is sufficiently
severe to warrant independent clinical
attention and is in excess of that usually seen
in intoxication or withdrawal

Yes

No
SUBSTANCE-INDUCED
SLEEP DISORDER
 Development of a reversible
syndrome due to recent use of a SUBSTANCE
Yes
substance INTOXICATION

No

Development of a syndrome due to

SUBSTANCE
reduction or cessation of use of a
WITHDRAWAL
substance
Yes

No
Clinically significant symptoms due to SUBSTANCE-
substance that do not meet criteria for Yes RELATED DISORDER
one of the Substance-Induced NOS
Disorders

No

No Substance-Induced Disorder
 DIFFERENTIAL DIAGNOSIS OF

MOOD DISORDERS
 Depressed,
elevated,
expansive, or
irritable mood
 Due to the direct MOOD DISORDER
physiological effects of a DUE TO A GENERAL
general medical condition Yes MEDICAL CONDITION

No

Due the direct SUBSTANCE-

physiological effects of a INDUCED MOOD
substance Yes
DISORDER

No

Determine type of present

and past mood disorders

No
 Elevated, expansive, or
irritable mood, at least 1 week
duration; marked impairment Yes MANIC EPISODE
or hospitalization

No

Elevated, expansive, or irritable

mood, at least 4-day duration; HYPOMANIC
changes observable by others EPISODE
but less severe than a Manic
Episode Yes

No
At least 2 weeks of depressed mood
or loss of interest plus associated MAJOR
symptoms, and not better DEPRESSIVE
accounted for by Bereavement Yes EPISODE

No

Criteria met for Manic Episode and

Major Depressive Episode nearly MIXED EPISODE
everyday for at least 1 week
Yes

No
Has never had a MANIC Yes Psychotic symptoms No
EPISODE or a MIXED occur at times other BIPOLAR I
EPISODE than during Manic or DISORDER
Mixed Episode
No
Yes
SCHIZOAFFECTIVE
DISORDER,
Occurred exclusively BIPOLAR TYPE
Yes
during Schizoaffective
Disorder

BIPOLAR
DISORDER NOS
No
Has never had a HYPOMANIC
EPISODE and at least 1 MAJOR BIPOLAR II DISORDER
DEPRESSIVE EPISODE Yes

No

2+ years of hypomanic
symptoms and periods of CYCLOTHYMIC
depressed mood DISORDER

Yes

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

No
Has never had a MAJOR Psychotic symptoms MAJOR
DEPRESSIVE EPISODE occur at times other DEPRESSIVE
Yes than during Major No DISORDER
Depressive Episodes

No
SCHIZOAFFECTI
Yes
VE DISORDER,
DEPRESSIVE
Occurred exclusively TYPE
during Schizoaffective Yes
Disorder
DEPRESSIVE
DISORDER NOS
No
Depressed mood, more days than not,
for at least 2 years with associated DYSTHYMIC DISORDER
symptoms Yes

No

Depressed mood not meeting criteria ADJUSTMENT DISORDER

for one of above Mood Disorders that WITH DEPRESSED MOOD
develops in response to a stressor Yes

No
 Clinically significant depressive
symptoms that do not meet criteria DEPRESSIVE
Yes
for a specific Mood Disorder DISORDER NOS

No

No Mood Disorder
DIFFERENTIAL DIAGNOSIS OF

PSYCHOTIC
DISORDERS
 Delusions,
hallucinations,
disorganized
speech, or grossly
disorganized
behavior
 PSYCHOTIC DISORDER
Due to the direct physiological effect
Yes DUE TO A GENERAL
of a general medical condition
MEDICAL CONDITION

No

SUBSTANCE-
Due to the direct physiological INDUCED
effects of a substance PSYCHOTIC
Yes DISORDER

No
 Symptoms of active Major Depressive or
phase of Schizophrenia, Manic Episode
lasting for at least 1 Yes concurrent with active-
month phase symptoms

No Yes No

Total duration of
mood episodes has SCHIZOPHRE
Duration of at Yes
been brief relative NIA
least 6 months
to duration of
active and residual
periods
No
SCHIZOPHRENIFORM
DISORDER
 SCHIZOAFFECTIVE
At least 2 weeks of DISORDER
Yes
delusions or
hallucinations in the
absence of prominent
mood symptoms

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

No PSYCHOTIC
DISORDER NOS
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