How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis

J Autism Dev Disord. 2020 Jun;50(6):2102-2127. doi: 10.1007/s10803-019-03967-5.

Abstract

We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0-26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2-16.0), p < 0.001], and Asperger's [23.3% (12.9-38.5), p = 0.001]; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6-58.0), p = 0.52]. Less than one-third [28.8% (13.9-50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.

Keywords: Asperger’s Disorder; Autism Spectrum Disorder; DSM-5; Diagnosis; PDD-NOS; Social Communication Disorder.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Autism Spectrum Disorder / diagnosis*
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Social Communication Disorder