Child Study Center, Yale University School of Medicine, PO Box 207900, New Haven, CT 06520-7900, USA.
Mol Autism. 2013 May 15;4(1):13. doi: 10.1186/2040-2392-4-13.
Since Kanner's first description of autism there have been a number of changes in approaches to diagnosis with certain key continuities . Since the Fourth edition of the Diagnostic and Statistical Manual (DSM-IV) appeared in 1994 there has been an explosion in research publications. The advent of changes in DSM-5 presents some important moves forward as well as some potential challenges.
The various relevant studies are summarized.
If research diagnostic instruments are available, many (but not all) cases with a DSM-IV diagnosis of autism continue to have this diagnosis. The overall efficiency of this system falls if only one source of information is available and, particularly, if the criteria are used outside the research context. The impact is probably greatest among the most cognitively able cases and those with less classic autism presentations.
Significant discontinuities in diagnostic practice raise significant problems for both research and clinical services. For DSM-5, the impact of these changes remains unclear.
自 Kanner 首次描述自闭症以来，诊断方法发生了许多变化，但某些关键的连续性仍然存在。自 1994 年第四版《精神疾病诊断与统计手册》（DSM-IV）问世以来，研究出版物如雨后春笋般涌现。DSM-5 的出现带来了一些重要的进步，也带来了一些潜在的挑战。
总结了各种相关研究。
如果有研究诊断工具，许多（但不是全部）符合 DSM-IV 自闭症诊断的病例仍将保留这一诊断。如果只有一个信息来源，特别是如果在研究背景之外使用标准，那么该系统的整体效率就会下降。这种影响在认知能力最强的病例和那些具有不太典型自闭症表现的病例中可能最大。
诊断实践中的显著不连续性给研究和临床服务都带来了重大问题。对于 DSM-5，这些变化的影响仍不清楚。
