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Case-Based Differential Diagnostic Mental Health Evaluation for Adults
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
Neurocognitive disorders (NCDs) are unique among DSM-5 categories in that there are NCD syndromes (e.g., major, mild), as well as NCDs due to underlying disease entities (e.g., NCD due to Alzheimer's disease [AD]) (APA, 2013). Sadock et al. (2019) classify major NCDs into one of three conditions: (1) delirium, (2) dementia, and (3) other cognitive disorders. However, the DSM-5 no longer uses the term “dementia” as a diagnosis, but instead uses NCD with etiological subtypes (e.g., AD, frontotemporal lobar degeneration, Lewy body disease, and vascular disease). All criteria for NCDs are based upon defined cognitive domains.
Mental illness
Published in Govert den Hartogh, What Kind of Death, 2023
But this is difficult to make out. “How can one be sure that one is not unwittingly colluding with a person's pathology rather than respecting a persons’ well-considered judgment?”40 At the least, therefore, there are, in the case of a request from a psychiatric patient, reasons always to require expert examination of his competence41 (Sections 3.5; 11.6). One reason is that some categories of mental illness – neurocognitive disorders and intellectual disabilities – involve a clear diminishing of the relevant cognitive abilities, and other categories – e.g., major depressive, bipolar and anxiety disorders – a risk of impaired capacity due to the impact of the disorder on the patient's mood and emotions. In some conditions, in particular in psychotic and bipolar disorders, the patient is often unaware of his own mental illness,42 in other conditions, depressive disorders in particular, he is aware of the medical facts, but often fails to appreciate their significance43 (Section 3.3). The reason may be that he can only imagine one possible future, a very bleak one, and is unable to think through alternative possibilities.44 Another reason may be that the meaning of the death wish needs to be clarified. And even in cases in which it would be understandable as a response to the actual condition of the patient and his circumstances that need not be his real or primary motive.
Digital health for chronic disease management
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Kelvin K.F. Tsoi, Martin C.S. Wong
Natural ageing unavoidably induces slight cognitive changes, such as impairments in memory, attention, language ability and agility. For cases where these cognitive changes do not interrupt daily activities, they are regarded as normal and natural. By contrast, when such changes lead to preserved functional activities or even severely obstruct conversational abilities, ones might be suffered from neurocognitive disorders, including mild cognitive impairment (MCI) or dementia, rather than normal ageing. Globally, over half of the dementia cases (61.7%) remain undetected, as a recent meta-analysis suggested. An exceptionally high prevalence rate of dementia was observed in low-income regions, 93.2% in Asia, compared to 62.9% in North America and 53.7% in Europe (Lang et al., 2017).
The psychological benefits of neuropsychological assessment feedback as a psycho-educational therapeutic intervention: A randomized-controlled trial with cross-over in multiple sclerosis
Published in Neuropsychological Rehabilitation, 2023
Wendy A. Longley, Robyn L. Tate, Rhonda F. Brown
There is mounting evidence supporting the psychological benefits of psychological assessment feedback as a therapeutic intervention for patients within the clinical psychological and counselling assessment settings, where small-to-medium sized effects (d = 0.403–0.423) are typically reported following feedback (Aschieri et al., 2016; Hanson & Poston, 2011; Poston & Hanson, 2010). However, there is currently no comparable supporting evidence within the clinical neuropsychological assessment (NPA) setting. Many patients with neurocognitive disorders can have significant cognitive impairments, and thus may not be able to fully comprehend, recall, or respond meaningfully to the feedback. Furthermore, some patients with neurocognitive disorders are at risk of becoming extremely distressed, traumatized, or suicidal, after receiving “bad news” confirming significant cognitive impairment or diagnosis of a progressive condition such as dementia or multiple sclerosis (MS), where recovery is not expected (Bronnum-Hansen et al., 2005; Carletto et al., 2018; Chalfant et al., 2004; Draper et al., 2010; Dubois et al., 2015). It cannot be assumed, therefore, that the same therapeutic benefits of psychological assessment feedback found in the clinical psychological and counselling assessment settings will necessarily generalize to the NPA setting.
Serum neurofilament light levels are correlated to long-term neurocognitive outcome measures after cardiac arrest
Published in Brain Injury, 2022
Erik Blennow Nordström, Gisela Lilja, Susann Ullén, Kaj Blennow, Hans Friberg, Christian Hassager, Jesper Kjærgaard, Niklas Mattsson-Carlgren, Marion Moseby-Knappe, Niklas Nielsen, Susanna Vestberg, Henrik Zetterberg, Tobias Cronberg
The performance-based measure utilized in this outcome model was the Mini-Mental State Examination (MMSE) (26), an 11-item screening on global cognitive impairment assessing cognitive domains such as orientation, memory, attention, language, and visuospatial ability. The MMSE scores ranges from 0 to 30 and lower scores indicate greater cognitive impairment. For this study, we only used MMSE results from face-to-face administration. The cutoff level recommended for mild cognitive impairment is < 27, with a level of < 21 classifying moderate-severe impairment (26). The widely used instrument has reasonable diagnostic validity to identify major neurocognitive disorder in a specialist setting, but it exhibits floor and ceiling effects in advanced and very mild neurocognitive disorders, respectively (27). The internal consistency and test–retest reliability has been judged as satisfactory, test performance can however be affected by age, education, cultural background, and emotional problems (28).
“I remember when … ”: The impact of reminiscence therapy on discourse production in older adults with cognitive impairment
Published in International Journal of Speech-Language Pathology, 2020
Naomi Rose, Anne Whitworth, Sharon Smart, Elizabeth Oliver, Jade Cartwright
The number of people living with mild cognitive impairment (MCI) and dementia is expected to accelerate globally in coming years, with growing interest in evidence-based interventions that have potential to enhance cognitive ability, participation in everyday activities, psychosocial wellbeing, and quality of life (Folkerts, Roheger, Franklin, Middelstädt, & Kalbe, 2017). While the clinical syndrome of dementia, more recently termed major neurocognitive disorder (DSM-5; American Psychiatric Association, 2013) is seen within a range of neurological conditions, each having unique pathology and presentation, cognitive decline in one or more domains is always present (DSM-5, 2013). Memory loss is frequently the major component of decline and the most common early symptom of dementia (Budson, 2014). In the early stages of Alzheimer’s disease, which accounts for half of people who have dementia (Burns & Iliffe, 2009), memory impairment is within both working memory, where sensory information is processed, and the episodic memory subsystem of declarative long-term memory, with deficits resulting in increasing difficulties receiving and encoding new information to create memories (Budson, 2014).