Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic
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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.
KeywordsAutism Spectrum Disorder Diagnosis Prevalence DSM-5
Funding was provided by the Medical Research Council (MRC, UK), the EU Autism Imaging Study (AIMS) network (Grant Agreement: 115300), and the National Institute for Health Research Biomedical Research Centre for Mental Health at King’s College London, Institute of Psychiatry and South London and Maudsley National Health Service Foundation Trust. The authors wish to thank all the participants involved in this study. Also the administrative support staff at the Behavioural Genetics Clinic: Frances Harwood, Pauline Domingo and Marie Simpson.
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