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The Implications of DSM V: Changes in Diagnostic Outcomes in An Adult Clinical Sample Re-Diagnosed According to the Proposed DSM

Posted May 17 2012 6:28pm

The Implications of DSM V: Changes in Diagnostic Outcomes in An Adult Clinical Sample Re-Diagnosed According to the Proposed DSM V is a talk to be given at IMFAR on Saturday. Given the very high focus on the DSM V from the online autism community, I had hope that this study might shed some light on the topic. IMFAR is a forum for preliminary work, and the abstract in this case shows that:

Background: Major changes in diagnostic criteria are proposed for DSM-V, including the collapsing of autistic disorder, Asperger’s disorder and PDD-NOS into a single diagnosis; ‘autism spectrum disorder (ASD)’. The effects of these changes are as yet unclear; will individuals diagnosed by current criteria still meet diagnostic criteria with the proposed diagnostic scheme? While some work has been reported addressing this issue in children, no studies in adults have been published to date. Adults, including those first receiving a diagnosis in adulthood, are an important, and somewhat neglected, group in autism spectrum clinical services and research and are the focus for the present study.
Objectives: To review the effect of proposed DSM V diagnostic algorithms on the diagnostic outcome of a clinical sample of patients assessed for ASD in adulthood.

Methods: Diagnostic information was reviewed for 100 consecutive adult patients who attended the Behavioural Genetics Clinic, a specialist clinic providing assessment of ASD at the Maudsley Hospital, London. Original diagnosis was made in accordance with the ICD-10 criteria. Diagnostic assessment included a detailed neuropsychiatric interview, Autism Diagnostic Interview-Revised (ADI-R) and / or Autism Diagnostic Observation Schedule (ADOS) pending consent to contact parents/parental availability and physical examination. Information from the ICD 10 algorithm, ADI-R, ADOS and neuropsychiatric assessment reports was used to recode diagnostic outcomes in accordance with the proposed DSM 5 ASD algorithm as posted by the American Psychiatric Association.

Results: Data will be presented showing the degree of agreement between current ICD 10 diagnoses (Asperger’s Syndrome, Childhood Autism, Atypical Autism, Pervasive Developmental Disorder-not otherwise specified) and the proposed new DSM 5 diagnosis of ASD.

Conclusions: Implications for proposed changes to diagnostic criteria will be highlighted.

The abstract tells us little about results, just that they will be “presented showing the degree of agreement between current ICD 10 diagnoses (Asperger’s Syndrome, Childhood Autism, Atypical Autism, Pervasive Developmental Disorder-not otherwise specified) and the proposed new DSM 5 diagnosis of ASD

  1. farmwifetwo:
    Not sympathetic to those that aren't happy with the changes. My eldest has gone from mild non-verbal PDD to mild ASD in 12yrs. He "passes for normal" academically, verbally, social skills are catching up all the time.... We took him to the Child Psych a couple of months ago expecting to change to ADHD. Turns out, we're still ASD.... PER THE IV. The inability to concentrate is the ASD + puberty. It's expected to come and go with the hormones. BUT, come #V, we're "social communication disorder". Which means all those adults like him. All those aspies who don't have significant delays yet managed to get the Cdn gov't to stop giving the disability tax credit to their parents... The ID that have verbal issues but are social... Are gone off the dx.... Which means children like his 10yr old bro.... those with actual autism.... will remain. I am looking forward to the changes. No more, people with dx's like my eldest's. The one's that "pass for normal", have jobs, lives, children... will no longer be hijacking the dx and turning it from a disability to a "way of being". Instead per the V it will have to "impact daily functioning" (aspie, pdd, asd).... Finally.
  2. Anne:
    From my experience with submitting conference abstracts, the deadline for the conference is early enough that the statistics may not be ready to quote in the abstract.
  3. Roger Kulp:
    Farmwifetwo,I could not agree with you more,and it also it seems,do the people who do the actual day to day grunt work in seeing people all across the spectrum,and doing the research. I think it it is a big step towards more realistic diagnostic criteria.I know in some cases,like mine,it would even give me a slightly more severe ASD diagnosis than the one I had under the DSM-IV,as well as helping to clarify it more.I suspect this might be the case with a lot of people.The DSM-IV description seems to work better,the more more severe the diagnosis is,which is why those who you describe don;t like it.People who have never had to fight being put in group homes or institutions,as I have,more than once.Twice in the last four years. Ideally I would like to see a separate group of secondary criteria.Things that would be important in determining the severity of the autism,but not the presence of the autism itself.Thing like,but not limited to,seizures,GI disease,nonverbal learning disorders,hearing and visual impairments.

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