or soon after substance intoxication or withdraw al or after exposure to a medication or toxin,
and the substance/medication must be capable of producing the symptoms (Criterion B). Sub-
stance/medication-induced obsessive-compulsive and related disorder due to a prescribed
treatment for a mental disorder or general medi cal condition must have its onset while the in-
dividual is receiving the medi cation. Once the treatment is discontinued, the obsessive-com-
pulsive and related disorder symp toms will usually improve or remit within days to several
weeks to 1 month (depending on the half-life of the substance/medica tion). The diagnosis of
substance/medication-induced obsessive-comp ulsive and related disorder should not be
given if onset of the obsessive-compulsive an d related disorder symp toms precedes the sub-
stance intoxicati on or medication use, or if the symp toms persist for a substantial period of
time, usually longer than 1 month,  from the time of severe into xication or with drawal. If the
obsessive-compulsive and related disorder symptoms persist for a substantial period of time,
other causes for the symptoms should be cons idered. The substance/medication-induced ob-
sessive-compulsive and related disorder diagnosis should be made in addition to a diagnosis
of substance intoxication only when the sympto ms in Criterion A pred ominate in the clinical
picture and are sufficiently severe to warrant independent clinical attention
Associated Features Supporting Diagnosis
Obsessions, compulsions, hair pulling, skin pick ing, or other body-focused repetitive be-
haviors can occur in association with intoxication with the following classes of substances:
stimulants (including cocaine) and other (o r unknown) substances. Heavy metals and tox-
ins may also cause obsessive-compulsive and related disorder symptoms. Laboratory as-