Neurocognitive Disorders

  1. Major and mild neurocognitive disorder

In DSM-5, the diagnosis of major neurocognitive disorder is based on


  1. Both impairment on objective measures of cognitive function, and impairment in independent completion of daily activities as an effect of this cognitive impairment.
  2. Whether or not the cognitive impairment is sufficient to interfere with independent completion of activities of daily living.
  3. Expressed as a percentile score, the severity of cognitive impairment on objective testing (relative to appropriate norms) required to support a diagnosis of major neurocognitive disorder is below the 3rd percentile.

Case Example:

Amy, a seventy-two-year old widow, lives by herself in a senior retirement home. In the last six months, she shows more difficulty with managing daily routines that she often enjoys doing. She also began mixing up dates with events that do not match or did not happen at all. She spends more time by herself and is easily agitated by other residents who come to her door without any prior arrangement. She is known as an easy-going lady who never complains about anything. Yet, she has been doing the opposite in recent months. Amy complains about her neighbours making too much noise, and about having people knocked on her door in the middle of the night. When the resident superintendent went through some of the tape on the surveillance camera, he did not find anything suspicious. He also talked to some residents about the noise issue and found no evidence to support Amy’s claim.


  1. Personality disorders

Personality disorders are associated with ways of thinking and feeling about oneself and others that

significantly and adversely affect how an individual functions in many aspects of life.


They fall within 10 distinct types: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, antisocial personality disorder, borderline personality disorder, histrionic personality, narcissistic personality disorder, avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.


Borderline personality disorder is a more common personality disorder.

Borderline personality disorder is a mental health disorder characterized by the presence of a distorted self-image, extreme emotions and impulsiveness, highly changeable moods that can last for several days or for just a few hours, an intense fear of abandonment or rejection, a history of unstable intense relationships that can change drastically from intense love and to intense hate, inappropriate anger that push others away and cause long-term feelings of isolation.

Many people experience one or more of the above symptoms regularly, but a person with borderline personality disorder will experience many of the symptoms listed above consistently throughout adulthood.

Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age.

Borderline personality disorder symptoms vary from person to person and women are more likely to have this disorder than men.


Case Example:

Jane was adopted at four after being in the care of CAS for more than two years. Her parents separated since she was six months old. Jane’s mother died of an overdose fifteen years ago, and her father was deported from Canada twelve years ago due to very serious crimes he committed in this country. Jane’s adopted parents have two children who are one and three years older than Jane.

Jane and her adopted parents and siblings have a very intense and unstable relationship. She was described by her adopted parents as a very emotional child. Jane has left home many times and would swear on the bible that she would never want to see her family again. When her adopted parents and siblings reached out to her, she would not answer their calls. However, she would call a few weeks later crying to them and complained about them being selfish and not caring for her being alone and feeling miserable.

Jane often gets into new relationships very quickly and intensely, but none of these relationships lasted. This happened to her work as well. Jane often started a new job with so much good things to say about the employer and about her co-workers. Yet, it often took only a short time to hear from her all kinds of negative comments she would make about these people. One major issue everyone knows about Jane is her changeable mood and unexpected emotional outburst. For this reason, she pushes others away but complains about them being disloyal and non-empathetic. When she was let go by her employers, she complains about being mistreated by them.


DISCLAIMER: Description of each of the mental issue is intended for a quick reference only. You are advised not to use it for self-diagnosis. If you have concerns about your mental health conditions, you are advised to seek medical advice from your family doctor or from a psychiatrist. If you already have a confirmed diagnosis of a mental health issue and you are considering counselling as an alternative treatment, you are encouraged not to stop taking medications without discussing and consulting with your family doctor or psychiatrist. Please also mention to your medical professionals about seeking counselling if you can.