Mnemonics for DSM-IV Substance-Related
Disorders
Harold B. Pinkofsky, M.D., Ph.D., and Roy R. Reeves, D.O., Ph.D
Abstract: A series of acronyms was developed to assist in
recalling the DSM-IV diagnostic criteria for substance-related
disorders. In order to facilitate recall, most of the mnemonics
are related in some way to the disorder itself. In general, each
letter of the acronym relates to an element of the diagnostic
criteria. These mnemonics are intended to be helpful in a
variety of academic and medical settings. © 1998 Elsevier
Science Inc.
Introduction
Substance abuse is a frequently encountered problem in the inpatient population. In order to help
identify features associated with the various forms
of substance intoxication and withdrawal we have
developed a list of mnemonics based on criteria in
the DSM-IV. These mnemonics are intended to help
organize criteria in a variety of clinical settings and
to assist in preventing faulty recall. They have been
found to be helpful in teaching the DSM-IV criteria
to residents within our teaching program. Mnemonics for selected DSM-III-R and DSM-IV disorders were previously published in an attempt to
assist with criterion recollection [1–3].
Alcohol Intoxication
The six features from criterion C can be remembered by “SAM’S GIN.”
S
A
-SPEECH SLURRED
-ATTENTION IMPAIRMENT OR
Departments of Psychiatry at Louisiana State University Medical Center, Box # 33932, Shreveport, Louisiana 71130 (H.B.P.)
and Overton Brooks VA Medical Center, Shreveport, Louisiana
(R.R.R.).
Address reprint requests to: Harold B. Pinkofsky, M.D., Ph.D.,
Louisiana State University Medical Center, School of Medicine
in Shreveport, Department of Psychiatry, P.O. Box 33932, 1501
Kings Highway, Shreveport, LA 71130-3932, USA.
368
ISSN 0163-8343/98/$19.00
PII S0163-8343(98)00052-8
M
S
-MEMORY IMPAIRMENT
-STUPOR OR COMA
G
I
N
-GAIT UNSTEADY
-INCOORDINATION
-NYSTAGMUS
Criterion C for “Sedative, hypnotic, or anxiolytic
intoxication” can also be recalled by the mnemonic
“SAM’S GIN.”
Alcohol Withdrawal
The eight features of criterion B can be recalled
using the mnemonic “PAST NITE” (as in an individual who is experiencing symptoms of withdrawal from decreased intake over the past several
nights).
P
A
S
T
-PSYCHOMOTOR AGITATION
-ANXIETY
-SEIZURES (GRAND-MAL)
-TRANSIENT HALLUCINATIONS
OR ILLUSIONS
N
I
T
E
-NAUSEA OR VOMITING
-INSOMNIA
-TREMOR (hand) INCREASED
-EXCITABILITY-AUTONOMIC
Criterion B of “sedative, hypnotic, or anxiolytic
withdrawal” can also be recalled by the mnemonic
“PAST NITE.”
Amphetamine Intoxication
The nine features from criterion C can be recalled
using the mnemonic “A CODE BLUE.”
General Hospital Psychiatry 20, 368 –370, 1998
© 1998 Elsevier Science Inc. All rights reserved.
655 Avenue of the Americas, New York, NY 10010
Mnemonics DSM-IV Disorders
A
C
O
D
E
B
L
U
E
-AGITATION OR RETARDATION
(psychomotor)
-CARDIAC (tachycardia or
bradycardia)
-OCULAR (pupillary dilation)
-DIAPHORESIS (or chills)
-ENCEPHALOPATHIC-LIKE
CHANGES (seizures, confusion,
dyskinesias, dystonias, or coma)
-BLOOD PRESSURE (elevated or
lowered)
-LOSS OF STOMACH CONTENT
-UNSTABLE MUSCLEASSOCIATED CHANGES
(diaphramatic, cardiac, and
skeletal) i.e., muscle weakness,
respiratory depression, chest pain,
or cardiac arrhythmias
-EVIDENCE OF WEIGHT LOSS
Criterion C for “cocaine intoxication” can also be
recalled by “A CODE BLUE.”
Amphetamine Withdrawal
The five features from criterion B can be recalled by
the mnemonic “PANTS” (as in an individual who
pants when out of breath).
P
A
N
T
S
-PSYCHOMOTOR AGITATION
OR RETARDATION
-APETITE INCREASES
-NIGHTMARES (vivid, unpleasant
dreams)
-TIREDNESS (fatigue)
-SLEEP (hypersomnia or insomnia)
Criterion B for “cocaine withdrawal” can also be
recalled by “PANTS.”
Cannabis Intoxication
The four features in criterion C can be recalled by
the mnemonic “MEAT.” (The mnemonic is in reference to a possible increase in apetite.)
M
E
A
T
-MOUTH DRY
-ERYTHEMATOUS
CONJUNCTIVA
-APETITE INCREASED
-TACHYCARDIA
Hallucinogen Intoxication
Criterion D can be recalled using the mnemonic
“DISTORT.”
D
I
S
T
O
R
T
-DISTORTED (blurred) VISION
-INCOORDINATION
-SWEATING
-TACHYCARDIA
-OPENING (dilation) OF THE
PUPIL
-RACING HEART (palpitations)
-TREMOR
Inhalant Intoxication
The 13 criterion C features can be recalled using the
mnenomic “DISRUPTS GLOBE.”
D
I
S
R
U
P
T
S
G
L
O
B
E
-DIZZINESS
-INCOORDINATION
-SLURRED SPEECH
-REFLEXES DEPRESSED
-UNSTEADY GAIT
-PSYCHOMOTOR
RETARDATION
-TREMORS
-STUPOR (or coma)
-GENERALIZED MOTOR
WEAKNESS
-LETHARGY
-OCULAR (nystagmus)
-BLURRED VISION (or diploplia)
-EUPHORIA
Opioid Intoxication
Pupillary constriction (or dilation following an
overdose) is present along with one of three features from criterion C. These three features of criterion C can be recalled by the mnemonic “SAD.”
S
A
D
-SLURRED SPEECH
-ATTENTION (or memory)
IMPAIRMENT
-DROWSINESS (or coma).
Opioid Withdrawal
These nine features from criterion B can be recalled
by the mnemonic “ARMY FINDS” (as in a possible
369
H.B. Pinkofsky and R.R. Reeves.
headline: Army finds Opioid Withdrawal In
Troops).
A
R
M
Y
-ACHES (muscular)
-RHINORRHEA (or lacrimation)
-MOOD-DYSPHORIC
-YAWNING
F
I
N
D
S
-FEVER
-INSOMNIA
-NAUSEA (or vomiting)
-DIARRHEA
-SWEATING (piloerection, or
pupillary dilation)
Phencyclidine Intoxication
At least two of eight features from criterion C develop within an hour of phencyclidine use. These
eight features can be recalled by the mnemonic
“MAP STAND.”
370
M
A
P
S
T
A
N
D
-MUSCLE RIGIDITY
-ACUTE SENSE OF HEARING
(hyperacusis)
-PAIN (numbness to pain)
-SEIZURES (or coma)
-TACHYCARDIA (or
hypertension)
-ATAXIA
-NYSTAGMUS (vertical or
horizontal)
-DYSARTHRIA
References
1. Short DD, Workman EA, Morse JH, Turner RL: Mnemonics for eight DSM-III-R disorders. Hosp Community Psychiatry 43:642–644, 1992
2. Reeves RR, Bullen JA: Mnemonics for ten DSM-IV
disorders. J Nerv Ment Dis 138:550–551, 1995
3. Pinkofsky HB: Mnemonics for DSM-IV personality
disorders. Psychiatr Serv 48:1197–1198, 1997