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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.

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Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, 701 West 168th Street, New York, NY, 10032, USA.
Lucile Packard Children's Hospital at Stanford, 770 Welch Road, Palo Alto, CA, 94304, USA.
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.
Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.


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.


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


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