Psychiatrists approve vast changes to diagnosis manual
The familiar term "Asperger's disorder", which is characterized by significant difficulty in social interactions, is being dropped and abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD, it has been revealed.
However, dyslexia and other learning disorders will remain, the Huffington Post reported.
The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists and the changes were approved on Saturday.
Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide.
The manual is also important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.
This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor.
More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."
The aim is not to expand the number of people diagnosed with mental illness but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer, who chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.
One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder.
People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.
Some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.
However, experts say the revision will not affect their education services.
The new manual adds the term "autism spectrum disorder", which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under the umbrella diagnosis.
The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.
Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.
One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.
Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.