Reduction in Autism Diagnoses Observed With DSM-5

Use of DSM-5 linked to reductions in diagnosis of ASD, DSM-IV-TR autistic disorder, Asperger

TUESDAY, April 2, 2019 (HealthDay News) -- Use of the Diagnostic and Statistical Manual 5 (DSM-5) criteria for autism spectrum disorder (ASD) seems to have reduced the number of ASD diagnoses, according to a review published online March 9 in the Journal of Autism and Developmental Disorders.

Kristine M. Kulage, M.P.H., from the Columbia University School of Nursing in New York City, and colleagues examined changes in the frequency of ASD diagnoses since the DSM-5 publication in a five-year follow-up systematic review and meta-analysis. Data were included for 33 studies.

The researchers found that use of DSM-5 criteria indicates reductions in the diagnosis of ASD (20.8 percent; P < 0.001), DSM-IV-TR autistic disorder (10.1 percent; P < 0.001), and Asperger syndrome (23.3 percent; P = 0.001); a nonsignificant decrease was seen in pervasive developmental disorder-not otherwise specified (46.1 percent; P = 0.52). Overall, 28.8 percent (P = 0.06) of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for social communication disorder. Compared with earlier reviews, the findings suggested smaller decreases in ASD diagnoses.

"Our findings provide further insight regarding how the DSM-5 is being used nationally and internationally to diagnose, or failing to diagnose, those with ASD," Kulage said in a statement. "Future research is needed, as concerns remain for impaired individuals, who, because of the change in diagnostic criteria for ASD, may no longer qualify for treatment but still demonstrate a need for services."

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