A Comparison of DSM-IV Pervasive Developmental Disorder and DSM-5 Autism Spectrum Disorder Prevalence in an Epidemiologic Sample
A Comparison of DSM-IV Pervasive Developmental Disorder and DSM-5 Autism Spectrum Disorder Prevalence in an Epidemiologic Sample
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DOI：
10.1016/j.jaac.2013.12.021
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发表时间：
2014-05-01
影响因子：
13.3
通讯作者：
Leventhal, Bennett L.
中科院分区：
文献类型：
--
作者：
Kim, Young Shin;Fombonne, Eric;Leventhal, Bennett L.
目的：DSM-5中发现的自闭症诊断标准的变化可能会影响自闭症谱系障碍（ASD）的患病率，研究结果，诊断过程以及临床和其他服务的资格。使用我们发表的韩国总人口患病率数据，我们计算DSM-5 ASD和社会沟通障碍（SCD）患病率，并将其与DSM-IV广泛性发育障碍（PDD）患病率估计值进行比较。我们还描述了以前诊断为DSM-IV PDD的个体，当诊断与DSM-5标准发生变化时。方法：目标人群为韩国社区中7至12岁的所有儿童（N = 55，266）、普通和特殊教育学校的儿童以及残疾登记处的儿童。我们使用自闭症谱系筛查问卷进行系统的、多信息者的筛查。筛查阳性儿童的父母使用标准化诊断程序进行全面评估，包括自闭症诊断访谈修订版和自闭症诊断观察计划。最佳估计的临床诊断采用DSM-IV PDD和DSM-5 ASD和SCD标准。结果：DSM-5 ASD患病率为2.20%（95%可信区间= 1.77-3.64）。DSM-5 ASD和SCD合并患病率与DSM-IV PDD患病率几乎相同（2.64%）。大多数患有自闭症障碍（99%），自闭症障碍（92%）和PDD-NOS（63%）的儿童符合DSM-5 ASD标准，而分别有1%，8%和32%符合SCD标准。其余所有儿童（2%）有其他精神病理学，主要是注意力缺陷/多动障碍和焦虑症。结论：我们的研究结果表明，大多数既往患有DSM-IV PDD的个体符合DSM-5 ASD和SCD的诊断标准。PDD、ASD或SCD;现有的诊断标准确定了一大批需要循证服务的具有临床意义的个人和家庭。
Objective: Changes in autism diagnostic criteria found in DSM-5 may affect autism spectrum disorder (ASD) prevalence, research findings, diagnostic processes, and eligibility for clinical and other services. Using our published, total-population Korean prevalence data, we compute DSM-5 ASD and social communication disorder (SCD) prevalence and compare them with DSM-IV pervasive developmental disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSM-IV PDD when diagnoses change with DSM-5 criteria. Method: The target population was all children from 7 to 12 years of age in a South Korean community (N = 55,266), those in regular and special education schools, and a disability registry. We used the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview Revised and Autism Diagnostic Observation Schedule. Best-estimate clinical diagnoses were made using DSM-IV PDD and DSM-5 ASD and SCD criteria. Results: DSM-5 ASD estimated prevalence was 2.20% (95% confidence interval = 1.77-3.64). Combined DSM-5 ASD and SCD prevalence was virtually the same as DSM-IV PDD prevalence (2.64%). Most children with autistic disorder (99%), Asperger disorder (92%), and PDD-NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8%, and 32%, respectively, met SCD criteria. All remaining children (2%) had other psychopathology, principally attention-deficit/hyperactivity disorder and anxiety disorder. Conclusion:. Our findings suggest that most individuals with a prior DSM-IV PDD meet DSM-5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD; extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services.