Other Specified Depressive Disorder 183
condition, b) the probability that the associ ated medical condition has a potential to pro-
mote or cause a depressive disorder, and c) a course of the depressive symptoms shortly
after the onset or worsening of  the medical condition, especially if the depressive symp-
toms remit near the time that the medical disorder is effectively treated or remits.
Medication-induced depressive disorder. An important caveat is that some medical con-
ditions are treated with medications (e.g., steroi ds or alpha-interferon) that can induce depres-
sive or manic symptoms. In these cases, clinical  judgment, based on all the evidence in hand, is
the best way to try to separate the most likely and/or the most important of two etiological fac-
tors (i.e., association with the medical condition vs. a substance-induced syndrome).
Adjustment disorders. It is important to differentiate a depressive episode from an ad-
justment disorder, as the onset of the medical co ndition is in itself a life stressor that could
bring on either an adjustment disorder or an episode of major depression. The major dif-
ferentiating elements are the pervasiveness the depressive picture and the number and
quality of the depressive symptoms that the pa tient reports or demonstrates on the mental
status examination. The differential diagnosis of the associated medical conditions is rel-
evant but largely beyond the scope of the present manual. 
Comorbidity
Conditions comorbid with depressive disorder  due to another medical condition are those
associated with the medical conditions of etio logical relevance. It has been noted that de-
lirium can occur before or along with depres sive symptoms in individuals with a variety
of medical conditions, such as Cushing’s di sease. The association of anxiety symptoms,