Gabbatore I, Marchetti Guerrini A, Bosco F M
Department of Psychology, GIPSI Research Group, University of Turin, Italy.
Associazione La Nostra Famiglia - IRCCS Eugenio Medea, Bosisio Parini, Italy.
Heliyon. 2023 Aug 9;9(8):e19062. doi: 10.1016/j.heliyon.2023.e19062. eCollection 2023 Aug.
Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder.
The search strategy was defined by combining the following keywords: "social pragmatic communication disorder," "DSM-5," "differential diagnosis," and "child." The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review.
After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases.
SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies.
自2013年《精神疾病诊断与统计手册》第5版（DSM-5）引入社交（语用）沟通障碍（SPCD）以来，科学界就其在诸如自闭症谱系障碍（ASD）和特定语言障碍（SLI）等其他临床类别鉴别诊断中的作用展开了一场辩论。事实上，SPCD的标准与这些诊断实体在沟通和语用技能方面存在共同缺陷。现有的评估工具似乎稀缺且不够灵敏，难以阐明诊断标准和临床界限。本研究旨在回顾关于SPCD诊断筛查的现有文献，以突出所研究领域中的混杂变量、与其他诊断实体的重叠以及现有评估工具在识别该障碍核心缺陷方面缺乏特异性的问题。
通过组合以下关键词来定义检索策略：“社交语用沟通障碍”“DSM-5”“鉴别诊断”和“儿童”。检索在三个数据库中进行：医学文献数据库（PubMed）、Scopus和科学引文索引。纳入综述的所有研究均发表于2013年至2023年4月之间，以英文撰写，且主要关注SPCD。
在筛选纳入标准后，18项研究被纳入综述。这些研究大多旨在调查SPCD与其他诊断类别（如特定语言障碍和自闭症谱系障碍）之间的鉴别诊断。在这些研究中，只有6项是专门的实验研究，其他则基于先前收集的数据库。
正如DSM-5所强调的，SPCD似乎有其自身的特点和特征，表明其临床相关性。然而，缺乏特定的工具和一些混杂变量使得难以识别SPCD并将其与其他诊断实体区分开来。需要进一步的研究来克服缺乏特定临床工具和实证研究的问题。
