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

• Published in: Soa--chʻŏngsonyŏn chŏngsin ŭihak = Journal of child & adolescent psychiatry Vol. 29; no. 4; pp. 178 - 184
• Main Authors: Lim, Yun Shin, Park, Kee Jeong, Kim, Hyo-Won
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한소아청소년정신의학회 01.10.2018; Korean Academy of Child and Adolescent Psychiatry
• Subjects: Adults; Age; Autism; Cognition & reasoning; Cognitive ability; Communication; Intellectual disabilities; Intelligence tests; Medical records; Mental disorders; Original; Patients; Pediatrics; Social interaction; Variables; United States > US; South Korea; pervasive developmental disorder; Diagnostic and Statistical Manual of Mental Disorders-5; Diagnostic and Statistical Manual of Mental Disorders-IV; Autism spectrum disorder
• ISSN: 1225-729X; 2233-9183
• DOI: 10.5765/jkacap.180016

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). 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. 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. 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.