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《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)与第五版(DSM-5)自闭症谱系障碍临床诊断分类比较

A Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder.

作者信息

Yaylaci Ferhat, Miral Suha

机构信息

Karaman State Hospital, Child and Adolescent Psychiatry Unit, Universite Mah., 1984 Sk., No: 1, Karaman, Turkey.

Dokuz Eylul University Hospital, Child and Adolescent Psychiatry Unit, Izmir, Turkey.

出版信息

J Autism Dev Disord. 2017 Jan;47(1):101-109. doi: 10.1007/s10803-016-2937-8.

Abstract

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.

摘要

本研究的目的是比较根据《精神疾病诊断与统计手册第四版,修订版》(DSM-IV-TR)和《精神疾病诊断与统计手册第五版》(DSM-5)诊断系统被诊断为广泛性发育障碍(PDD)的儿童。纳入了150名年龄在3至15岁之间、被DSM-IV-TR诊断为PDD的儿童。基于DSM-IV-TR和DSM-5标准,通过精神病学评估对PDD症状进行了复查。使用儿童自闭症评定量表(CARS)和自闭症行为检查表(ABC)确定临床严重程度。发现DSM-5的诊断率有统计学意义的下降(19.3%)。使用DSM-5诊断为PDD和未诊断为PDD的儿童在年龄和症状严重程度上存在显著差异。DSM-5中的B4标准是最常见的标准。结果表明,根据DSM-IV-TR标准被诊断为PDD的个体可能无法使用DSM-5标准进行诊断。

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