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Neurocognitive disorders: Cluster 1 of the proposed meta-structure for DSM-V and ICD-11

Paper 2 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

Published online by Cambridge University Press:  01 October 2009

P. Sachdev ,
G. Andrews ,
M. J. Hobbs ,
M. Sunderland  and
T. M. Anderson
P. Sachdev*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
G. Andrews
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
M. J. Hobbs
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
M. Sunderland
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
T. M. Anderson
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
*
*Address for correspondence: Professor P. Sachdev, Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick NSW 2031, Australia. (Email: p.sachdev@unsw.edu.au)
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Abstract

Background

In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. In this paper, we consider the validity of the first cluster, neurocognitive disorders, within this proposal. These disorders are categorized as ‘Dementia, Delirium, and Amnestic and Other Cognitive Disorders’ in DSM-IV and ‘Organic, including Symptomatic Mental Disorders’ in ICD-10.

Method

We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force as applied to the cluster of neurocognitive disorders.

Results

‘Neurocognitive’ replaces the previous terms ‘cognitive’ and ‘organic’ used in DSM-IV and ICD-10 respectively as the descriptor for disorders in this cluster. Although cognitive/organic problems are present in other disorders, this cluster distinguishes itself by the demonstrable neural substrate abnormalities and the salience of cognitive symptoms and deficits. Shared biomarkers, co-morbidity and course offer less persuasive evidence for a valid cluster of neurocognitive disorders. The occurrence of these disorders subsequent to normal brain development sets this cluster apart from neurodevelopmental disorders. The aetiology of the disorders is varied, but the neurobiological underpinnings are better understood than for mental disorders in any other cluster.

Conclusions

Neurocognitive disorders meet some of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster. Further developments in the aetiopathogenesis of these disorders will enhance the clinical utility of this cluster.

Keywords

ClassificationdementiadeliriumDSM-VICD-11mild cognitive impairmentneurocognitive disorders
Type
Thematic section: A proposal for a meta-structure for DSM-V and ICD-11
Information
Psychological Medicine , Volume 39 , Issue 12 , December 2009 , pp. 2001 - 2012
Copyright
Copyright © Cambridge University Press 2009

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