Underestimation of autism spectrum disorders according to DSM-5 criteria: A pilot study

2017 ◽  
Vol 41 (S1) ◽  
pp. S459-S460
Author(s):  
R. Ferrara ◽  
M. Esposito

IntroductionRecent studies on autism concern the number of individuals diagnosed with pervasive developmental disorder (PDD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 autism spectrum disorder (ASD). ASD is diagnosed using the impairments in two dimensions:– the social and communication dimension;– the restricted and repetitive interests and behaviors (RRIB) dimension whereas PDD is diagnosed using impairments in three dimensions.All the studies indicate between 50 and 75% of individuals will maintain diagnoses.ObjectivesThe aim of the study is to quantify how many individuals with previous PDD diagnoses under DSM-IV-TR criteria would maintain a diagnosis of ASD under DSM-5 criteria.MethodsOur sample consists of 23 cases (21 males, 2 female) related to the treatment Centre “Una breccia nel muro” of Rome and Salerno. All the cases previous received a PDD diagnose according to DSM-IV TR criteria. The mean age of cases was 7.7 years. All the cases were diagnosed by our team according to DSM-5 criteria, clinicians also used to make diagnoses: the Autism Diagnostic Observation Schedule-2, the Autism Diagnostic Interview-Revised.ResultsEighty-seven percent of cases with PDD were classified as ASD using DSM-5 criteria. Thirteen percent of cases, that previous received an Asperger diagnose, did not meet the ASD criteria (Fig. 1).ConclusionsDSM-5 criteria may easily exclude cases with high functioning from ASD because they tend to be atypical for ASD according to this study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Autism ◽  
2021 ◽  
pp. 136236132110396
Author(s):  
Sarah Wittkopf ◽  
Sanna Stroth ◽  
Anika Langmann ◽  
Nicole Wolff ◽  
Veit Roessner ◽  
...  

Autism spectrum disorder shares many symptoms with other mental health disorders, and comorbid disorders such as mood and anxiety disorders are common, making the diagnostic process challenging. We aimed to explore the diagnostic accuracy of two standard autism spectrum disorder diagnostic instruments and to identify those behavioral items that best differentiate between autism spectrum disorder and mood and anxiety disorder in a naturalistic sample of patients utilizing autism spectrum disorder specialist services. The study included data of 847 participants (5–65 years of age, n = 586 with autism spectrum disorder, n = 261 with mood and anxiety disorder) all evaluated with the Autism Diagnostic Observation Schedule in the context of the diagnostic process. Data of the Autism Diagnostic Interview–Revised were available for 428 participants (5–51 years of age, n = 367 with autism spectrum disorder, n = 61 with mood and anxiety disorder). By means of binominal logistic regressions and an ensemble feature selection, we identified a subset of items that best differentiated between autism spectrum disorder and mood and anxiety disorder. Overall, the results indicate that a combination of communicational deficits and unusual and/or inappropriate social overtures differentiates autism spectrum disorder and mood and anxiety disorder. Aspects of social cognition are also relevant. Limitations of the current study and implications for research and practice are discussed. Lay abstract Symptoms of mood and anxiety disorders overlap with symptoms of autism spectrum disorder, making the diagnostic process challenging. This study found that a combination of communicational deficits and unusual and/or inappropriate social overtures facilitates differentiation between autism spectrum disorder and mood and anxiety disorders. Furthermore, the results confirm the essential need of a behavioral observation with the Autism Diagnostic Observation Schedule in combination with a full Autism Diagnostic Interview–Revised to support diagnostic decisions.


Autism ◽  
2017 ◽  
Vol 21 (5) ◽  
pp. 564-572 ◽  
Author(s):  
Maureen Samms-Vaughan ◽  
Mohammad H Rahbar ◽  
Aisha S Dickerson ◽  
Katherine A Loveland ◽  
Manouchehr Hessabi ◽  
...  

The administration requirements of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview–Revised, widely used in high-income countries, make them less feasible for diagnosis of autism spectrum disorder in low- and middle-income countries. The flexible administration requirements of the Childhood Autism Rating Scale have resulted in its use in both high-income countries and low- and middle-income countries. This study examines the agreement between assessments using the Childhood Autism Rating Scale with those using the Autism Diagnostic Observation Schedule or Autism Diagnostic Observation Schedule, Second Edition and Autism Diagnostic Interview–Revised in Jamaica. Children aged 2–8 years (n = 149) diagnosed with autism by an experienced clinician using the Childhood Autism Rating Scale were re-evaluated using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview–Revised. The proportion diagnosed with autism spectrum disorder using the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview–Revised was determined and mean domain scores compared using analysis of variance (ANOVA). The mean age was 64.4 (standard deviation = 21.6) months; the male:female ratio was 6:1. The diagnostic agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule and Autism Diagnostic Observation Schedule, Second Edition was 100.0% and 98.0%, respectively. Agreement with the Autism Diagnostic Interview–Revised was 94.6%. Domain scores were highest for children with more severe symptoms (p < 0.01). Despite a high level of agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview–Revised, the Childhood Autism Rating Scale should be evaluated further with a broader range of autism spectrum disorder symptomatology, and by clinicians with varying experience before recommendation for use in low- and middle-income countries.


2015 ◽  
Vol 21 (3) ◽  
pp. 144-152 ◽  
Author(s):  
Mohammad Javad Tarrahi ◽  
Afarin Rahimi-Movaghar ◽  
Hojjat Zeraati ◽  
Seyed Abbas Motevalian ◽  
Masoumeh Amin-Esmaeili ◽  
...  

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. ‘Legal problems' and ‘desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion.


Author(s):  
Sandra Kooij ◽  
Philip Asherson ◽  
Michael Rösler

In this chapter, the diagnostic assessment of ADHD in adults is described, starting with the clinical picture, such as the symptoms and the areas of impairment. To start the diagnostic process, screening instruments may be used. During diagnostic assessment, collateral information and neuropsychological tests have their role. The assessment of frequently occurring comorbidity with other psychiatric disorders, such as mood, anxiety, sleep, personality, and autism spectrum disorders, as well as addiction, is necessary to complete the clinical picture. Also, differential diagnosis is part of the diagnostic process. Finally, the Diagnostic Interview for ADHD in adults (DIVA 2.0), and the Conners Adult ADHD Diagnostic Interview (CAADID) are described and discussed. Instructions for use of the DIVA are given. The adjustments in the DSM-5 criteria for ADHD, and the next edition of DIVA based on the DSM-5 criteria, DIVA-5, are described.


Author(s):  
Sven Bölte ◽  
Luise Poustka ◽  
Hilde M. Geurts

Autism spectrum disorder (ASD) is an early onset and persistent condition defined by alterations in social communication and social interation alongside repetitive, restricted stereotypic behaviours and interests causing disabilities. Until recently, research on the co-occurrence of ADHD with ASD has been limited by DSM-IV criteria, allowing no dual diagnosis of these two neurodevelopmental disorders. Since the DSM-5 permits a double diagnosis of ADHD plus ASD, research on their comorbidity has substantially increased. In addition to shared and distinct aetiological factors, studies have revealed a high clinical impact of the combined symptomatology on individual outcomes. This chapter provides a selective overview of behavioural, cognitive, and biological findings as well as intervention strategies in combined ADHD/ASD phenotypes.


2013 ◽  
Vol 25 (3) ◽  
pp. 643-652 ◽  
Author(s):  
Laura Gutermuth Anthony ◽  
Lauren Kenworthy ◽  
Benjamin E. Yerys ◽  
Kathryn F. Jankowski ◽  
Joette D. James ◽  
...  

AbstractAlthough circumscribed interests are pathognomonic with autism, much about these interests remains unknown. Using the Interests Scale (IS), this study compares interests between 76 neurotypical (NT) individuals and 109 individuals with high-functioning autism spectrum disorder (HF-ASD) matched groupwise on age, IQ, and gender ratio. Participants and their parents/caregivers completed diagnostic measures (the Autism Diagnostic Interview—Revised and the Autism Diagnostic Observation Schedule; HF-ASD only), cognitive tests (Wechsler IQ Scales), and questionnaires (the Repetitive Behavior Scale—Revised, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale), in addition to the IS. Consistent with previous research, HF-ASD and NT individuals did not differ in number of interest areas, but the types of interests and intensity of those interests differed considerably. Using only the IS intensity score, 81% of individuals were correctly classified (NT or HF-ASD) in a logistic regression analysis. Among individuals with HF-ASD, Interests Scale scores were significantly related to Autism Diagnostic Observation Schedule, Behavior Rating Inventory of Executive Function, Repetitive Behavior Scale—Revised, and Social Responsiveness Scale scores, but they were not related to Autism Diagnostic Interview—Revised scores, IQ, gender, age, or psychotropic medication use. The type and intensity, but not the number, of interests distinguish high-functioning individuals with ASD from NT individuals.


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