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More often than not, individuals exhibiting psychotic symptoms may be diagnosed as having a SUD (Substance Use Disorder) (American Psychiatric Association, 2009). Disentangling the link between psychotic disorders and Substance Use Disorder is a common diagnostic challenge for researchers within community settings and clinicians within treatment settings (Miner, 2007).
For diagnosis of individuals with psychotic symptoms and SUDs, a manual of diagnostic and statistical of mental disorders, attempts to make a distinction between psychotic disorders like schizophrenia and bipolar disorder) and SUDs (like dementias and delirium). Most SUDs are short lived and can be resolved with sustained abstinence. However, the manual is challenged by practical difficulties within distinguishing between independent psychoses and substance-induced disorders and by rising evidence that use of marijuana can be a causative factor of schizophrenia (American Psychiatric Association, 2009).
One of the common challenge or difficulty for psychiatric diagnosis or judgment is posed by patients experiencing the onset of psychotic disorder symptoms at episodes of current psychoactive substance use (Miner, 2007). In the manual of diagnostic and statistical of mental disorders, all major classifications of nonorganic psychotic disorders entail an exclusion criterion stating that symptoms are not resulting from direct substance physiological effects (Miner, 2007). However, in practice distinguishing whether a psychotic symptom is resulting from drug effects is unclear.
For example, in a research of episodes of psychosis researchers were unable to have a clear diagnosis within 25 out of 278 cases. Moreover, substance abuse was a common cause of ambiguity in diagnosis (Miner, 2007). A study characterized sources of confusion in diagnosis within a study of one hundred and sixty five patients having substance abuse and chronic psychosis on whom a distinctive diagnosis could not be specified (Miner, 2007). Most frequent factors identified to be clouding diagnosis included insufficient abstinence, poor memory, as well as inconsistent reporting.


Miner C. (2007). Differential diagnosis of substance-induced psychosis and schizophrenia in patients with substance use disorders. Schizophr Bull, 23(1), 187-193.
American Psychiatric Association, (2009). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.