subtype criteria here have been harm onized with those expert criteria.
Specifiers
Evidence for distinct be havioral features in NCDs has been recognized, particularly in the
areas of psychotic symptoms and depression . Psychotic features are common in many
NCDs, particularly at the mild-to-moderate stage of major NCDs due to Alzheimer’s dis-
ease, Lewy body disease, an d frontotemporal lobar degene ration. Paranoia and other
delusions are common features, and often a persecutory theme may be a prominent aspect
of delusional ideation. In contrast to psychotic disorders with onset in earlier life (e.g.,
schizophrenia), disorganized speech and diso rganized behavior are not characteristic of
psychosis in NCDs. Hallucinations may occur in any modality, although visual hallucina-
tions are more common in NCDs than in de pressive, bipolar, or psychotic disorders.
Mood disturbances, including depression, anxiety, and elat ion, may occur. Depression
is common early in the course (including at the mild NCD level) of NCD due to Alzhei-
mer’s disease and Parkinson’s disease, while elation may occur more commonly in fron-
totemporal lobar degeneration. When a full a ffective syndrome meetin g diagnostic criteria
for a depressive or bipolar disorder is pres ent, that diagnosis should be coded as well.
Mood symptoms are increasingly recognized to be a significant feature in the earliest stages
of mild NCDs such that clinical recogn ition and intervention may be important.
Agitation is common in a wide variety of NCDs, particularly in major NCD of moder-
ate to severe severity, and often occurs in th e setting of confusion or frustration. It may