ICD-11 Criteria for Disorders Due to Use of Caffeine (6C48 )
Disorders due to use of caffeine
are characterised by the pattern and consequences of caffeine use. Caffeine is
a mild psychostimulant and diuretic that is found in the beans of the coffee
plant (Coffea species) and is a constituent of coffee, cola drinks, chocolate,
a range of proprietary 'energy drinks' and weight-loss aids. It is the most
commonly used psychoactive substance worldwide and several clinical conditions
related to its use are described, although severe disorders are comparatively
rare considering its ubiquity. Caffeine Intoxication related to consumption of
relatively higher doses (i.e., > 1 g per day) is described. Caffeine
Withdrawal is common upon cessation of use among individuals who have used
caffeine for a prolonged period or in large amounts. Caffeine-Induced Anxiety
Disorder has been described, often following intoxication or heavy use.
Exclusions:
- Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone (6C46)
- Hazardous use of caffeine (QE11.5)
6C48.0 Episode of Harmful Use of Caffeine
An episode of caffeine use that
has caused damage to a person’s physical or mental health. Harm to health of
the individual occurs due to one or more of the following: (1) direct or
secondary toxic effects on body organs and systems; or (2) a harmful route of
administration. This diagnosis should not be made if the harm is attributed to
a known pattern of caffeine use.
Exclusions:
- Harmful pattern of use of caffeine (6C48.1)
6C48.1 Harmful Pattern of Use of Caffeine
A pattern of caffeine use that has
caused clinically significant harm to a person’s physical or mental health or
in which caffeine-induced behaviour has caused clinically significant harm to
the health of other people. The pattern of caffeine use is evident over a
period of at least 12 months if use is episodic and at least one month if use
is continuous (i.e., daily or almost daily). Harm may be caused by the
intoxicating effects of caffeine, the direct or secondary toxic effects on body
organs and systems, or a harmful route of administration.
Exclusions:
- Episode of harmful use of caffeine (6C48.0)
6C48.10 Harmful pattern of use of caffeine, episodic
A pattern of episodic or
intermittent caffeine use that has caused damage to a person’s physical or
mental health. The pattern of episodic caffeine use is evident over a period of
at least 12 months. Harm to health of the individual occurs due to one or more
of the following: (1) direct or secondary toxic effects on body organs and
systems; or (2) a harmful route of administration.
Exclusions:
- Episode of harmful use of caffeine (6C48.0)
6C48.11 Harmful Pattern of use of Caffeine, Continuous
A pattern of continuous (daily or
almost daily) caffeine use that has caused damage to a person’s physical or
mental health. The pattern of continuous caffeine use is evident over a period
of at least one month. Harm to health of the individual occurs due to one or
more of the following: (1) direct or secondary toxic effects on body organs and
systems; or (2) a harmful route of administration.
Exclusions:
- Episode of harmful use of caffeine (6C48.0)
6C48.1Z Harmful Pattern of use of Caffeine, Unspecified
6C48.2 Caffeine Intoxication
Caffeine intoxication is a
clinically significant transient condition that develops during or shortly
after the consumption of caffeine that is characterised by disturbances in
consciousness, cognition, perception, affect, behaviour, or coordination. These
disturbances are caused by the known pharmacological effects of caffeine and
their intensity is closely related to the amount of caffeine consumed. They are
time-limited and abate as caffeine is cleared from the body. Presenting
features may include restlessness, anxiety, excitement, insomnia, flushed face,
tachycardia, diuresis, gastrointestinal disturbances, muscle twitching, psychomotor
agitation, perspiration or chills, and nausea or vomiting. Cardiac arrhythmias
may occur. Disturbances typical of intoxication tend to occur at relatively
higher doses (e.g., > 1 g per day). Very high doses of caffeine (e.g., >
5 g) can result in respiratory distress or seizures and can be fatal.
Coding Note: Code aslo the causing condition
6C48.3 Caffeine Withdrawal
Caffeine withdrawal is a
clinically significant cluster of symptoms, behaviours and/or physiological
features, varying in degree of severity and duration, that occurs upon
cessation or reduction of use of caffeine (typically in the form of coffee,
caffeinated drinks, or as an ingredient in certain over-the-counter
medications) in individuals who have used caffeine for a prolonged period or in
large amounts. Presenting features of Caffeine withdrawal may include headache,
marked fatigue or drowsiness, irritability, depressed or dysphoric mood, nausea
or vomiting, and difficulty concentrating.
Coding Note: Code aslo the causing condition
6C48.4 Certain Specified Caffeine-Induced Mental or Behavioural Disorders
Coding Note: Code aslo the causing condition
6C48.40 Caffeine-Induced Anxiety Disorder
Caffeine-induced anxiety disorder
is characterised by anxiety symptoms (e.g., apprehension or worry, fear,
physiological symptoms of excessive autonomic arousal, avoidance behaviour)
that develop during or soon after intoxication with or withdrawal from caffeine.
The intensity or duration of the symptoms is substantially in excess of anxiety
symptoms that are characteristic of Caffeine intoxication or Caffeine
withdrawal. The amount and duration of caffeine use must be capable of
producing anxiety symptoms. The symptoms are not better explained by a primary
mental disorder (e.g., an Anxiety and fear-related disorder, a Depressive
disorder with prominent anxiety symptoms), as might be the case if the anxiety
symptoms preceded the onset of the caffeine use, if the symptoms persist for a
substantial period of time after cessation of the caffeine use or withdrawal,
or if there is other evidence of a pre-existing primary mental disorder with
anxiety symptoms (e.g., a history of prior episodes not associated with caffeine
use).
Coding Note: Code aslo the causing condition
6C48.Y Other Specified Disorders Due to use of Caffeine
6C48.Z Disorders Due to use of Caffeine, Unspecified
REFERENCE:
International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
https://creativecommons.org/licenses/by-nc-nd/3.0/igo/
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