Southern New Hampshire University HSE 350 Worksheet for DSM-5 Criteria for Diagnosis of Substance Use Disorder
Note: Substance use disorder reguires that at least two criteria be met within a 12-month period
Diagnostic Criteria
Meets Criteria? Yes OR No
Evidence From the Case
1. Substance is often taken in larger amounts or over a longer period of time than intended.
NO
It is reported that Mr. Roy is only drinking on Fridays and Saturdays. No increase in use has been reported.
2.
There is a persistent desire or there are unsuccessful efforts to cut down or control substance use.
NO
There have been no efforts to stop or decrease use reported.
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
NO
There is nothing to support this currently.
4. There is a craving or a strong desire to use the substance.
NO YES
There are no reports of cravings. Mr. Roy is missing his son's athletic games due to drinking and reports continued drinking despite his wife's continued objections Mr. Roy continues to drink despite his wife's objections and requests.
5.
Recurrent substance use results in failure to fulfill major role obligations at work, school, or home. 6. Substance use continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
YES
7. Important social, occupational, or recreational activities are given up or reduced because of substance use.
YES
Mr. Roy is missing his son's athletic games
8. There is recurrent substance use in situations in which it is physically hazardous.
NO
There is none reported currently.
There is continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. 10. * Tolerance, as defined by either of the following:
NO
There have been no physical or psychological problems reported.
NO
Not reported.
a) A need for markedly increased amounts of the substance to achieve intoxication or desired effect b) Markedly diminished effect with continued use of the same amount of the substance
Southern New Hampshire University 11. ** Withdrawal, as manifested by either of the following: NO None reported.
a)The characteristic ffspecific substance) withdrawal syndrome b) The same ffor a closely related) substance is taken to relieve or avoid withdrawal symptoms
* This criterion is not considered to be met for those individuals taking the substance solely under appropriate medical supervision.
** The DSM-5 contains separate criteria lists for each type of substance. However, all use the same 11 criteria except for criterion 11ffa). Refer to the DSM-5 for specific withdrawal syndromes.
Severity: Mild: 2-3 symptoms Moderate: 4-5 symptoms Severe: 6 or more symptoms
Diagnosis: Alcohol Use Disorder, Mild
ICD-10-CM Diagnostic Code: 305.00 ffF10.10)
Signed: Wanda Prince
Date: January 20, 2022
DC: American Psychiatric Associ