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Thursday, January 23, 2014

DSM-5 and Prevalance

Many posts have discussed the potential impact of the fifth edition of the Diagnostic and Statistical Manual (DSM-5).  From CDC:
 JAMA Psychiatry has published a new study: “Potential impact of DSM-5 criteria on autism spectrum disorder (ASD) prevalence estimates.” Researchers found that estimates of the number of children with ASD might be lower using the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria than using the previous Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria.
You can read the article’s abstract here. Read more below for a summary of the findings from this study.
Main findings:
Over 80% of children who met the Autism and Developmental Disabilities Monitoring (ADDM) Network classification for ASD, which is based on DSM-IV-TR criteria, also had documented symptoms that met the DSM-5 criteria (which were published in May 2013).
The remaining 20% met the ADDM Network classification for ASD, but did not meet the DSM-5 criteria. However, many of those children were very close to meeting DSM-5 criteria and were missing only one of the necessary symptoms.
Children who met the ADDM Network classification for ASD were more likely to meet DSM-5 criteria if:
There were no differences between boys and girls or between White and Black children in their likelihood of meeting both the DSM-5 criteria and the ADDM Network classification for ASD.
The findings suggested that estimates of the number of children with ASD might be lower using the current DSM-5 criteria than using the previous DSM-IV-TR criteria.
As doctors and other clinicians start using the DSM-5 criteria, they might diagnose ASD using new or revised tools or they might document symptoms differently. These changes in everyday community practice could offset the DSM-5’s effect on estimates of the number of children with ASD.