J Korean Acad Child Adolesc Psychiatry.  2018 Oct;29(4):178-184. 10.5765/jkacap.180016.

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

• Lim YS
• Park KJ
• Kim HW

• KMID: 2436276
• DOI: http://doi.org/10.5765/jkacap.180016

Abstract

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.

Keyword

Autism spectrum disorder; Diagnostic and Statistical Manual of Mental Disorders-IV; Diagnostic and Statistical Manual of Mental Disorders-5; pervasive developmental disorder

MeSH Terms

Appointments and Schedules
Asperger Syndrome
Autism Spectrum Disorder*
Autistic Disorder*
Chungcheongnam-do
Diagnosis*
Diagnostic and Statistical Manual of Mental Disorders
Intelligence
Intelligence Tests
Medical Records
Prevalence
Prospective Studies
Retrospective Studies