• A. Panic attacks or anxiety is predominant in the clinical picture.

AND

• 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 Criterion A.

AND

• C. The disturbance is not better explained by an anxiety disorder that is not substance/medication-induced. Such evidence of an independent anxiety disorder could include

the following:

• The symptoms precede the onset of the substance/medication use; the symptoms persist 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 anxiety disorder

(e.g., a history of recurrent non-substance/medication-related episodes).

AND

• D. The disturbance does not occur exclusively during the course of a delirium.

AND

• E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Note: This diagnosis should be made instead of a diagnosis of substance intoxication or substance withdrawal only when the symptoms in Criterion A predominate in the clinical picture and they are sufficiently severe to warrant clinical attention.