142 Bipolar and Related Disorders
Substance/Medication-Induced
 Bipolar and Related Disorder
Diagnostic Criteria
A. A prominent and persistent disturbance in mood that predominates in the clinical picture
and is characterized by elevated, expansive, or irritable mood, with or without depressed
mood, or markedly diminished interest or plea sure in all, or almost all, activities.
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 a bipolar or related disorder that is not sub-
stance/medication-induced. Such evidence of an independent bipolar or related disor-
der could include the following:
The symptoms precede the onset of the substance/medication use; the symptoms per-
sist 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 bipolar 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.
Coding note:  The ICD-9-CM and ICD-10-CM codes fo r the [specific substance/medication]-
induced bipolar and related disorders are indicated in the table below. Note that the ICD-10-