focal weakness, unilateral incoordination, as ymmetrical reflexes). The most common neu-
rocognitive profile approximates that seen in vascular NCD. 
Associated Features Supporting Diagnosis
Intermediate-duration NC D induced by drugs with central nervous system depressant effects
may manifest with added symptoms of increased irritability, anxiety, sleep disturbance, and
dysphoria. Intermediate-duration NCD induced by stimulant drugs may manifest with re-
bound depression, hypersomnia, and apathy. In severe forms of substance/medication-
induced major NCD (e.g., associ ated with long-term alcohol use), there may be prominent
neuromotor features, such as incoordination, ataxia, and motor slowing. There may also be
loss of emotional control, including aggres sive or inappropriat e affect, or apathy.
Prevalence
The prevalence of these conditions is not know n. Prevalence figures for substance abuse are
available, and substance/medica tion-induced major or mild NCDs are more likely in those
who are older, have longer use, and have other risk factors such as nutritional deficits.
For alcohol abuse, the rate of mild NCD of intermediate duration is approximately 30%–
40% in the first 2 months of abstinence. Mild NCD may persist, particularly in those who do
not achieve stable abstinence until after age 50 years. Major NCD is rare and may result from
concomitant nutritional deficits, as in al cohol-induced amnestic  confabulatory NCD.
For individuals quitting cocaine, metham phetamine, opioids, phencyclidine, and sed-
ative, hypnotics, or anxiolytics, substance/medication-induced mild NCD of intermediate
duration may occur in one-third or more, and there is some evidence that these substances