Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Substance/Medication-Induced Psychotic Disorder


Differential Diagnosis

  • Hallucinogen persisting perception disorder (DSM-IV-TR)
  • Primary psychotic disorder
  • Psychotic disorder due to a general medical condition (DSM-IV-TR)
  • Psychotic disorder due to another medical condition
  • Substance intoxication or substance withdrawal
  • Substance intoxication or withdrawal, with perceptual disturbances (DSM-IV-TR)

Medical Codes

ICD-9-CM:
291.9 - Alcoholic Psychosis, Unspecified
292.2 - Pathological Drug Intoxication; Drug Reaction Resulting in Brief Psychotic States, NOS, Idiosyncratic, Pathologic
292.9 - Drug-induced Mental Disorder, Unspecified; Drug-related Disorder NOS; Organic Psychosis NOS Due to or Associated with Drugs

Overview

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), substance/medication-induced psychotic disorder appears under "Schizophrenia Spectrum and Other Psychotic Disorders." For the approach to substance dependence/abuse established by DSM-IV-TR, please refer to specific topics including Polysubstance Dependence; Alcohol and Drug Detoxification and Rehabilitation; Alcohol Intoxication, Acute; Alcoholism; Stimulant-Related Disorders (Amphetamine-Type Substance); Stimulant-Related Disorders (Cocaine); Cannabis Use Disorder; Tobacco Use Disorder; Opioid Dependence; or Sedative, Hypnotic or Anxiolytic Dependence.

Incidence and Prevalence: Prevalence of substance/medication-induced psychotic disorder in the general population is unknown. Substance/medication-induced psychotic disorder is reported in 7% to 25% of individuals with a first episode of psychosis in different settings (DSM-5).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Substance/medication-induced psychotic disorder as been associated with amphetamine (or a similar-acting sympathomimetic), phencyclidine, cocaine, alcohol, sedative, cannabis, and cocaine.

In elderly individuals, polypharmacy (use of four or more medications by a patient) for medical disease and exposure to drugs for Parkinsonism, cardiovascular disease, and other medical disorders may be associated with a greater likelihood of psychosis induced by prescription drugs.

Source: Medical Disability Advisor



Diagnosis

History: According to the DSM-5, individuals with substance/medication-induced psychotic disorder have delusions and/or hallucinations (that are prominent, DSM-IV-TR). The history reveals that the delusions and/or hallucinations developed in the course of, or shortly after (within 30 days, DSM-IV-TR), substance intoxication, or after withdrawal from or exposure to a medication. The involved substance/medication must be capable of producing delusions and/or hallucinations.

The disturbance is not better accounted for by a psychotic disorder that is not substance/medication-induced. Evidence of an independent psychotic disorder may include appearance of the symptoms before the onset of the substance/medication use; persistence of the symptoms for approximately 1 month after acute withdrawal from the substance/medication use, or symptoms that exceed those normally produced by the substance/medication use — as well as a history of recurrent non-substance/medication-related episodes.

The disturbance does not occur exclusively during the course of a delirium. The disturbance produces clinically significant distress or impairment in social, occupational, or other areas of functioning. This diagnosis should be made instead of a diagnosis of substance intoxication or substance withdrawal only when the delusions and/or hallucinations predominate in the clinical picture (only when the delusions and/or hallucinations exceed those usually associated with the intoxication, DSM-IV-TR) and when its severity warrants clinical attention. It is necessary to specify if the onset occurred during intoxication or during withdrawal. According to the DSM-5, it is also necessary to specify the current severity on a 5-point scale of the symptoms.

According to both the DSM-5 and DSM-IV-TR, coding of substance-induced psychotic disorder includes specifying the offending substance: alcohol; cannabis; phencyclidine or other hallucinogen; inhalant; sedative, hypnotic, or anxiolytic; cocaine; amphetamine or other stimulant, (or amphetamine-like substance, phencyclidine-like substance, or opioid, DSM-IV-TR); or other (or unknown) substance. In the DSM-5, coding includes "with use disorder, mild," "with use disorder, moderate or severe," or "without use disorder" for each substance based on the ICD-10-CM. In the DSM-IV-TR, coding includes either "with hallucinations" or "with delusions" for each substance.

Physical exam: Please refer to the physical exam for the particular psychotic disorder, and for dependence on/abuse of the particular substance/medication.

Tests: Please refer to the tests for the particular psychotic disorder, and for dependence on/abuse of the particular substance/medication.

Source: Medical Disability Advisor



References

Cited

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. American Psychiatric Association, 2013.

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association, 2000.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.