What are the clinical features of neurocognitive disorders

14 neurocognitive disorders

learning objectives 14

·  14.1 What forms of neurocognitive disorders are recognized in DSM-5? What is presumed to be the cause of these disorders?

·  14.2 What are the clinical features of neurocognitive disorders?

·  14.3 What is delirium and how is it treated?

·  14.4 What are the risk factors for Alzheimer’s disease? What changes in the brain are found in patients with Alzheimer’s disease?

·  14.5 How is Alzheimer’s disease treated?

·  14.6 What is an amnestic disorder? What causes amnestic disorders?

·  14.7 What are some of the clinical consequences of head trauma? What factors are related to the degree of impairment that results?

A Simple Case of Mania? A highly successful businessman, age 45, with no previous history of psychiatric disorder, began to act differently from his usual self. He seemed driven at work. His working hours gradually increased until finally he was sleeping only 2 to 3 hours a night; the rest of the time he worked. He became irritable and began to engage in uncharacteristic sprees of spending beyond his means.

Although he felt extremely productive and claimed he was doing the work of five men, the man’s boss felt otherwise. He was worried about the quality of that work, having observed several recent examples of poor business decisions. Finally, when the man complained of headaches, his boss insisted that he seek help. Source: Adapted from Jamieson & Wells,  1979 .

The case you have just read concerns a man who, on first glance, looks as if he might be having an episode of mania. In fact, he is suffering from four tumorous masses in his brain. Clues that this man has a brain disorder rather than a mood disorder include the facts that he is experiencing headaches at the same time as a major change in behavior and that he has no prior history of psychopathology (see Taylor, 2000 ). Clinicians always need to be alert to the possibility that brain impairment itself may be directly responsible for their patients’ symptoms. Failure to do so could result in serious diagnostic errors, as when a clinician falsely attributes a mood change to psychological causes and fails to consider a neuropsychological origin such as a brain tumor.