Gamlin Chloe
School of Clinical Medicine University of Cambridge, Lucy Cavendish College University of Cambridge, Cambridge, UK,
Psychiatr Danub. 2017 Sep;29(Suppl 3):214-218.
In 2013, the American Psychiatric Association removed Asperger's Disorder from the DSM, offering instead the new DSM-5 diagnosis: Autism Spectrum Disorder. This change has been hailed the most controversial exclusion from the DSM, yet unlike the 1973 removal of homosexuality from DSM-III, Asperger's disorder has not been demedicalised. Rather, the disorder has simply been reclassified as part of the DSM-5 Autism Spectrum and therefore retains its fundamental characteristic as a mental disorder owing to its inclusion within the sphere of the DSM.
This paper is based on a review of the current academic literature in conjunction with careful reading of the DSM-5.
Removing the Asperger's label, valued by patients for its distinctiveness from autism brings with it the potential to inflict iatrogenic harm.
This paper demonstrates how the DSM-5 reclassification has the potential to threaten the identity of those affected, and discusses the problem of autism as a stigmatizing diagnostic label.
A case is made for the use of tandem social/colloquial - medical/technical terminology to refer to the conditions classified under DSM-5 Autism Spectrum Disorder, in order to square the circle of social concerns regarding identity and stigma with the need for diagnostic clarity to continue to advance medical practice.
2013年，美国精神病学协会将阿斯伯格综合征从《精神疾病诊断与统计手册》（DSM）中移除，取而代之的是新的DSM-5诊断：自闭症谱系障碍。这一变化被誉为DSM中最具争议的排除，但与1973年将同性恋从DSM-III中移除不同，阿斯伯格综合征并未被非医学化。相反，该疾病只是被重新归类为DSM-5自闭症谱系的一部分，因此由于其被纳入DSM范畴而保留了其作为精神障碍的基本特征。
本文基于对当前学术文献的综述以及对DSM-5的仔细研读。
去除阿斯伯格综合征这一患者因其与自闭症的差异而重视的标签，有可能造成医源性伤害。
本文阐述了DSM-5的重新分类如何有可能威胁到患者的身份认同，并探讨了自闭症作为一个具有污名化作用的诊断标签的问题。
有人主张使用社会/通俗与医学/专业术语相结合的方式来指代DSM-5自闭症谱系障碍所涵盖的病症，以便在满足诊断清晰性以推进医学实践的需求与解决社会对身份认同和污名化的担忧之间找到平衡。
