Unifying Concepts

DSM-5 Criteria for Withdrawal Delirium (Delirium Tremens)

The criteria for withdrawal delirium, are delirium (a rapid-onset fluctuating disturbance of attention and cognition, sometimes with hallucinations) plus alcohol withdrawal.

DSM-5 Criteria for Withdrawal Delirium (Delirium Tremens)
A patient who meets the criteria for both alcohol withdrawal and delirium is considered to have withdrawal delirium.

Criteria for alcohol withdrawal
Cessation of or reduction in heavy and prolonged use of alcohol
At least two of eight possible symptoms after reduced use of alcohol:

  • Autonomic hyperactivity
  • Hand tremor
  • Insomnia
  • Nausea or vomiting
  • Transient hallucinations or illusions
  • Psychomotor agitation
  • Anxiety
  • Generalized tonic–clonic seizures

Criteria for delirium
Decreased attention and awareness
Disturbance in attention, awareness, memory, orientation, language, visuospatial ability, perception, or all of these abilities that is a change from the normal level and fluctuates in severity during the day
Disturbances in memory, orientation, language, visuospatial ability, or perception
No evidence of coma or other evolving neurocognitive disorders
The criteria are based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).



  1. Schuckit MA. Recognition and management of withdrawal delirium (delirium tremens). N Engl J Med. 2014 Nov 27;371(22):2109-13. [Medline]
  2. Manasco A, Chang S, Larriviere J, Hamm LL, Glass M. Alcohol withdrawal. South Med J. 2012 Nov;105(11):607-12. [Medline]
  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. DSM-5. Washington, DC: American Psychiatric Publishing, 2013.


Created: Feb 04, 2015.

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