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J Autism Dev Disord. 2019 Mar 9. doi: 10.1007/s10803-019-03967-5. [Epub ahead of print]

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

Author information

1
Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA. kk729@columbia.edu.
2
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
3
Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, 701 West 168th Street, New York, NY, 10032, USA.
4
Lucile Packard Children's Hospital at Stanford, 770 Welch Road, Palo Alto, CA, 94304, USA.
5
Department of Neurology, Division of Child Neurology, Columbia University Vagelos College of Physicians and Surgeons, 180 Fort Washington Avenue, 5th Floor, New York, NY, 10032, USA.
6
Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.

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

PMID:
30852784
DOI:
10.1007/s10803-019-03967-5

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