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

Psychol Med. 2009 Dec;39(12):2001-12. doi: 10.1017/S0033291709990262. Epub 2009 Oct 1.

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amnesia / classification*
  • Amnesia / diagnosis*
  • Amnesia / etiology
  • Bipolar Disorder / classification
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Cognition Disorders / classification*
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Comorbidity
  • Delirium / classification*
  • Delirium / diagnosis*
  • Delirium / etiology
  • Dementia / classification*
  • Dementia / diagnosis*
  • Dementia / etiology
  • Depressive Disorder, Major / classification
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Disease Progression
  • Humans
  • Intelligence
  • Middle Aged
  • Neuropsychological Tests
  • Obsessive-Compulsive Disorder / classification
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / psychology
  • Risk Factors
  • Schizophrenia / classification
  • Schizophrenia / diagnosis
  • Schizophrenic Psychology
  • Terminology as Topic