A pilot study on the diagnostic performance of DMS-IV and DMS-V for autism spectrum disorder

Abstract: 

Yang You, MD; Bai-Lin Wu, PhD; Yiping Shen, PhD*

The new diagnostic criteria for autism spectrum disorders (ASD) are due to be released in May 2013. The impact of changes made in the new criteria is yet to be evaluated. Here we performed a retrospective study on a cohort of ASD patients diagnosed by DSM-IV criteria, aimed to compare the diagnostic performances between DSM-IV and DSM-V. We reviewed the medical records of 163 patients with possible clinical diagnosis of ASD. Ninty-three (57%) of them met the DSM-IV criteria for Autistic disorder, the rest 70 cases were either PDD-NOS (n=39) or Asperger’s disorder (n=3) or without sufficient information in medical record to perform a clinical diagnosis (n=28). Upon re-evaluation using the new diagnostic criteria in DSM-V, only 60% of patients with previous diagnosis of autistic disorder met the new criteria. One individual who was previous diagnosed as PDD-NOS met the new diagnostic criteria for autistic disorder. The present study revealed a significant difference in diagnostic yield by new and old criteria. This pilot comparative study reveals that the ASD diagnostic criteria in DSM-V are stricter than that in DSM-IV and autism patients diagnosed using DMS-V criteria tend to be more severely affected. The new criteria will have immediate impact on the clinical diagnosis and management of individuals with neuodevelopmental disorders and it will affect the prevalence estimate of ASD in population as well.

Key Words: autism spectrum disorder, autistic disorder, PDD-NOS, DSM-IV, DSM-V autism spectrum disorder, autistic disorder, PDD-NOS, DSM-IV, DSM-V

Yang You, MD;1,2 Bai-Lin Wu, PhD;1,3 Yiping Shen, PhD1,2*
1 Departments of Laboratory Medicine and Pathology, Children’s Hospital Boston, Harvard Medical School, Boston, MA
2 Department of Child Development and Behavior, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
3 Children’s Hospital and Institutes of Biomedical Science, Fudan University, Shanghai, China

*Corresponding Author: Departments of Laboratory Medicine and Pathology, Children’s Hospital Boston, Harvard Medical School, Boston, MA 02115.
(Email: yiping.shen@childrens.harvard.edu)

CONFLICT OF INTEREST
None.

ACKNOWLEDGEMENT
This work was funded in part by Chinese National “973″ project on Population and Health (2010CB529601), National Natural Science Fund (30801345), Shanghai Municipal Science and Technology Commission (09JC1402400, 09ZR1404500), Shanghai Municipal Education Commission (08YZ41) and Shanghai university scientific selection and cultivation for outstanding young teachers in special fund (jdy09144), China.

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