Cognitive symptoms in primary psychotic disorders

This specifier may be used together with a diagnosis from the grouping of Schizophrenia or Other Primary Psychotic Disorders to indicate the degree to which cognitive impairment is a prominent aspect of the clinical presentation. Deficits may appear in any of the following cognitive domains: speed of processing, attention/concentration, orientation, judgment, abstraction, verbal or visual learning, or working memory. The cognitive impairment is not attributable to a Neurodevelopmental Disorder or to Delirium or another Neurocognitive Disorder or to the direct effects of a substance or medication on the central nervous system, including withdrawal effects. When available, the severity rating for this domain should be based on the results of locally validated, standardized neuropsychological assessments, but such measures are not available in all settings and are not required to provide a rating.

The rating should be made based on the severity of cognitive symptoms during the past week.

Table 6.12: Rating Scale for Cognitive Symptoms in Primary Psychotic Disorders

| | |

| - | - |

| None
6A25.5&XS8H
| No significant cognitive symptoms have been present during the past week. |

| Mild
6A25.5&XS5W
| Person has minor difficulties in cognition (e.g., difficulty with recall during the interview, concentration may drift, shows some disorientation to time but not person or place). Everyday functioning is largely unimpaired by the difficulties. |

| Moderate
6A25.5&XS0T
| Person shows clear difficulties in cognition (e.g., recall for some autobiographical information is impaired or inconsistent, cannot perform some basic operations that are expected of the person’s educational attainment and level of intellectual functioning such as simple calculation tasks, orientation disrupted for time and place but intact for person, difficulty learning or retaining new information). Everyday functioning is impaired as a result but only some external assistance is necessary. |

| Severe
6A25.5&XS25
| Person shows pronounced difficulties in cognition (e.g., severe deficits in verbal memory or other cognitive tasks relative to educational attainment and level of intellectual functioning, substantial difficulty with concentration and attention to what the rater asks during the interview, difficulty formulating plans to accomplish a specific objective, unable to consider alternative solutions to problems, orientation is grossly disturbed). The problems severely interfere with everyday functioning leading to the necessity of considerable external assistance. |

| Severity Unspecified
6A25.5
| Cognitive symptoms have been present during the past week, but it is not possible to make a severity rating based on the available information. |