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DSM-IV - Dementia Due to Other General Medical Conditions

[From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000.] ...

  1. The development of multiple cognitive deficits manifested by both

    1. memory impairment (impaired ability to learn new information or to recall previously learned information)
    2. one (or more) of the following cognitive disturbances:
      1. aphasia (language disturbance)
      2. apraxia (impaired ability to carry out motor activities despite intact motor function)
      3. agnosia (failure to recognize or identify objects despite intact sensory function)
      4. disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)
  2. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.
  3. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiological consequence of a general medical condition other than Alzheimer's disease or cerebrovascular disease (e.g., HIV infection, traumatic brain injury, Parkinson's disease, Huntington's disease, Pick's disease, Creutzfeldt-Jakob disease, normal-pressure hydrocephalus, hypothyroidism, brain tumor, or vitamin B12 deficiency).
  4. The deficits do not occur exclusively during the course of a delirium.

Code based on presence or absence of a clinically significant behavioral disturbance:
Without behavioral disturbance: if the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance.
With behavioral disturbance: if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance (e.g., wandering, agitation).
Coding note: Also code the general medical condition on Axis III (e.g., HIV infection, head injury, Parkinson's disease, Huntington's disease, Pick's disease, Creutzfeldt-Jakob disease).



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