Presence of delusions, hallucinations, or both.

• A. Schizophrenia
• B. Substance/Med Induced Psychotic Disorder
• C. Delusional Disorder
• D. Mood Disorder with psychotic features

Answer: (B)

Delusions and hallucinations signal psychosis, but the cause can be primary or secondary. The best-fitting explanation here is that psychotic symptoms caused directly by a substance or medication are categorized as Substance/Med Induced Psychotic Disorder. This diagnosis hinges on a clear temporal relationship: the psychotic symptoms emerge during intoxication, withdrawal, or after starting a medication, and there is evidence linking the symptoms to that substance or drug exposure.

Other disorders require different patterns: schizophrenia-like disorders need persistent psychotic symptoms over time with functional impact; delusional disorder centers on fixed delusions with little or no prominent hallucinations or mood disturbance; mood disorders with psychotic features require concurrent mood symptoms (depression or mania) with psychosis. When the presentation shows delusions or hallucinations but is temporally tied to a substance or medication, the Substance/Med Induced Psychotic Disorder diagnosis is the most appropriate unless the symptoms persist independent of use or after clearance of the substance.