Mild and Major Neurocognitive Disorders

wail Mild and Major Neurocognitive Disorders A m o n g t h e n e w d i a g n o s e s in D S M - 5 is t h e d i a g n o s i s o f mild neurocognitive disorder (see Table 1.5.6). T h i s diagnosis is c o n t r o v e r s i a l b e c a u s e o n l y a " m o d e s t " c o g n i t i v e d e c l i n e is n e e d e d (one or t w o standard d e v i a t i o n s b e l o w w h a t w o u l d be e x p e c t e d for a g i v e n p a t i e n t ) — a n d u n l i k e a l m o s t any o t h e r d i a g n o s i s in DSlVl-5, t h e s y m p t o m s d o not n e e d to cause distress or i m p a i r f u n c t i o n i n g . In fact, a r e q u i r e m e n t for the diagnosis is that f u n c t i o n i n g is n o t i m p a i r e d ! O n the o n e h a n d , this n e w diagnosis can focus the attention of researchers and clinicians on early signs of d e m e n tia (Geda & Nedelska, 2012; Gutierrez et al., 1994). T h e n e w diagnosis will m a k e it easier for researchers to investigate factors related to faster or slower decline, and clinicians m a y

able to i n t e r v e n e earlier w i t h n e w m e d i c a t i o n s that delay or arrest further declines. O n the o t h e r hand, the n e w t e r m can create confusion. T h e medical t e r m for the level of cognitive ability that is in b e t w e e n n o r m a l functioning and dementia (or major n e u r o cognitive disorder, in D S M - 5 lingo) is mild cognitive impairment. This is the term, neurologists use. So D S M - 5 has created a different t e r m , s o w i n g confusion for m e n t a l health clinicians, patients, and their families. Patients will receive t w o diagnoses for the same condition (Siberski, 2013). CRITICAL THINKING Given that neither distress nor impaired f u n c t i o n i n g are criteria, d o you t h i n k mild n e u r o c o g n i t i v e disorder should be considered a "disorder"? W h y or why not? (James Foley, College of Wooster)