A CASE PRESENTATION

FOR NEUROCOGNITIVE
DISORDERS
Elijah Leonardo Bolusa
John Donyell Dalisay
Peter Joshua Gomez

INTRODUCTION

In reference to Abnormal Psychology

(latest), NEUROCOGNITIVE
DISORDERis one of the main
categories for disorders itself.
HISTORY OF DISORDER:
Organic disorders (Early DSM'S).
Cognitive disorders (DSM-IV TR).
Neurocognitive disorder (DSM-V).

EPIDEMIOLOGY:
INCIDENCE:

Occurs more generally in Old age.

Occurs generally with a mental illness.

SEX:

In general, females are likely older.

Females to have more medical
comorbidity.

PREVALENCE:

Varies by age and etiological sub types.

Estimates are generally available for
old age.
Prevalance increases among 60 year
olds.
1-2% at age 65 years,while
30% by age 85.

AGE:

Generally in old age.

Generally to 60-85 years old.

ETIOLOGY
BIOLOGICAL

Alzheimer's
disease,Huntington,Parkinson's disease
and others.
Vitamin B and B12 defficiency.

GENETICS

Abnormal chormosome genes: 21, 19,

14, 12 and 1.
You have it in your genes.

PSYCHOSOCIAL FACTORS

Lifestyle,diet and stess influence.

NEUROCOGNITIVE DISORDERS
CLASSIFICATIONS OF DSM-5
1.) DELIRIUM
Specify conditions in the following fields:
A.) Substance Intoxication/Withdrawal or
Medication
Induced.
B.) Duration of the presence of symptoms.
C.) Psychomotor activity.

2.) OTHER SPECIFIED DELIRIUM

Does not meet the full criteria for
delirium and other NCDs; reason for not
meeting the criteria is mentioned in
diagnosis.

3.) UNSPECIFIED DELIRIUM

Reason for not meeting the criteria is
not mentioned in the diagnosis.

4.) MAJOR AND MILD NEUROCOGNITVE

DISORDER
MAJOR NEUROCOGNITVE DISORDER
-Significant cognitive deficits interfere with
independence.
Specify:
- With or without behavioral disturbance
- Severity (mild, moderate, severe).

B. MILD NEUROCOGNITVE
DISOREDER
- Modest cognitive deficits do not
interfere
with independence.
Specify:
- With or without behavioral
distrubance.

5.) MAJOR OR MILD FRONTOTEMPORAL

NEUROCOGNITVE DISORDER
- Insidious onset and gradual progression of
the disturbance.
- Behavioral Variant or Language Variant.
- Probable or Possible Frontotemporal
Neurocognitive Disorder.

6.)MAJOR OR MILD VASCULAR

NEUROCOGNITIVE DISORDER
- Clinical features are consistent with a
vascular
etiology.
- Sufficient evidence in medical history
leading to
NCD.

7.) SUBSTANCE/MEDICATION
INDUCED MAJOR OR MILD
NEUROCOGNITIVE DISORDER
NCD persists beyond usual duration of
intoxication.
substance and duration of use is capable
of producing NCD.
NCD is consistent with timing of
substance use.

MAJOR OR MILD NEUROCOGNITVE

DISORDER DUE TO:
- Major or mild NCD criteria are met.
- Insidious onset and gradual
progression.
8.) ALZHEIMER'S DISEASE
- evidence of a causative Alzheimers
disease gene
- no evidence of mixed etiology .

9.)TRAUMATIC BRAIN INJURY

- evidence of traumatic brain injury
- NCD is present immediately after
traumatic
event

10.) HIV INFECTION

- Documented infection of HIV
- Not better explained by non-HIV
conditions.

11.) PRION DISEASE

- Motor features (myoclonus, ataxia or
biomarker evidences).

12.) PARKINSON'S DISEASE

- Parkinsons disease precedes onset of
NCD.

13.) LEWY BODIES

- NCD development subsequent to

spontaneous features of Parkinsonism.

14.) HUNTINGTON'S DISEASE

- Clinically established genetic risk of
the disease.

15.) OTHER MEDICAL CONDITION

- historical laboratory evidence that
NCD
is consequence of other medical
condition

16.) MULTIPLE ETIOLOGIES

- Evidence that NCD is consequence of
more
than one etiological process
- Excluding stubstances.

17.) UNSPECIFIED NEURO

COGNITIVE DISORDER
- Characteristics of NCD cause clinically
significant
distress but do not meet the full criteria
of any cognitive disorder.

CLINICAL CASE FORMULATION

PROFILE OF THE CLIENT
NAME: Mr. C.
AGE: 55 yrs. old.
PLACE OF BIRTH: Tarlac City, Tarlac.
CURRENT ADDRESS: Romualdez St., Manila.
REFERRED TO CLINICIAN BY: Mrs. C (wife).
DATE REFERED TO CLINICIAN: July 14,
2015.

MENTAL STATUS EXAMINATION

APPERANCE: Semi-ungroomed, with facial

hair, Bald.
BEHAVIOR: Disorganize, Restless, and
Confused.
EMOTION: Irritated, Melancholic,
aggressive at times.
THOUGHT PRPOCESS: Forget what is
going on, unfocused.

THOUGHT CONTENT: Memory recall

difficulty, Grammatical Error
COGNITION AND INTELLECTUAL
RESOURCES: Difficulty in
concentration

CLINICAL CASE HISTORY

- Mr. C is an outstanding librarian;
Perfectionist.
- Increased difficulty in thought expression.
- Developed difficulty in concentration and
neglected grooming.
- Given an early retirement because of
impairment
- Feels that he lost at his own home.
- Got lost at his own neighborhood.

ASSESMENT
WAIS-R
Full Scale IQ 80; Borderline
Poor Results of performance test
Severely disabled memory recall
Visual Analysis
Significant grammatical error

ASSESMENT
PROJECTIVE TESTS.
Possible Organicity
Forgets about the instructions
Can give him a state of emotional
disturbance
Possible poor psychological control
Possible brain damage

DIAGNOSIS
UNSPECIFIED NEUROCOGNITIVE
DISORDER
Significant cognitive decline
Cognitive deficits in everyday activities
Deficits doesnt fit the context of delirium
Deficits arent caused by other mental
disorders

DIAGNOSIS
Unspecified because it does not fall on
any category of other NCDs

Further testing must be done to identify

the cause (e.g. Lewy body, HIV, etc.)

TREATMENT PLAN
Identify the cause of the disorder
(e.g. Biological or Psychosocial Factor)
Prescription of specific medicine to tackle
the cause of the disorder
Adjunctive Therapy(Regulation of
neurotransmitters)
Cognitive Behavioral Therapy ( Management of
Impaired Functions)

Reference
Suri, R. (2012). Sandplay: An Adjunctive
Therapy to Working With Dementia.
International Journal of Play Therapy. 2012,
Vol.21, No. 3, 117-130
NICE (2015). Dementia: Supporting People
with Dementia and their Carers in Health
and Social Care. Retrieved From:
http://www.nice.org.uk/guidance/cg42/resour
ces/guidance-dementia-pdf

American Psychiatric Association.

(2013).Diagnostic and statistical
manual of mental disorders(5th ed.).
Arlington, VA: American Psychiatric
Publishing.
David H. Barlow and V. Mark Durand
(2015), Abnormal Psychology, An
Integrative Approach, Seventh
Edition.University Of South FloridaSt.Petersburg.