Autism Spectrum Disorder Diagnosis in Diagnostic and Statistical Manual of Mental Disorders-5 Compared to Diagnostic and Statistical Manual of Mental Disorders-IV

OBJECTIVES: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). METHODS: We retrospectively reviewed the medical records of 170 subjects (age range: 3–23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. RESULTS: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. CONCLUSION: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.

Criteria evolution of autism spectrum disorders and the significance of the criteria in Diagnostic and Statistical Manual of Mental Disorders 5th ed / 中华实用儿科临床杂志

Autism spectrum disorders have gradually been known and its concept is also changing.It is important that comprehend the changing timely for clinical work.This paper is mainly about the formation and evolution for the term,as well as the change in Diagnostic and Statistical Manual of Mental Disorders 5th ed and the significance.