Original Paper

Journal of Autism and Developmental Disorders

, Volume 43, Issue 11, pp 2515-2525

Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic

  • C. Ellie WilsonAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust Email author 
  • , Nicola GillanAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Deborah SpainAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Dene RobertsonAffiliated withBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Gedeon RobertsAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Clodagh M. MurphyAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Stefanos MaltezosAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Janneke ZinkstokAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
  • , Katie JohnstonAffiliated withBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
    • , Christina DardaniAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s College
    • , Chris OhlsenAffiliated withBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
    • , P. Quinton DeeleyAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
    • , Michael CraigAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
    • , Maria A. MendezAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust
    • , Francesca HappéAffiliated withDepartment of Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, King’s College
    • , Declan G. M. MurphyAffiliated withDepartment of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King’s CollegeBehavioural Genetics Clinic, Maudsley Hospital, South London and Maudsley NHS Foundation Trust

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Abstract

An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56 % met DSM-5 ASD criteria. A further 19 % met DSM-5 (draft) criteria for Social Communication Disorder. Of those diagnosed with Autistic Disorder/Asperger Syndrome on DSM-IV-TR, 78 % met DSM-5 ASD criteria. Sensitivity of DSM-5 was significantly increased by reducing the number of criteria required for a DSM-5 diagnosis, or by rating ‘uncertain’ criteria as ‘present’, without sacrificing specificity. Reduced rates of ASD diagnosis may mean some ASD individuals will be unable to access clinical services.

Keywords

Autism Spectrum Disorder Diagnosis Prevalence DSM-5