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

Abstract

Introduction

Recent 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.

Objectives

The 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.

Methods

Our 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.

Results

Eighty-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).

Conclusions

DSM-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 interest

The authors have not supplied their declaration of competing interest.

Fig. 1 Autism spectrum disorder according to DSM-5.