The comparison of DSM-IV-TR and DSM-5 diagnostic classifications in the clinical diagnosis of autistic spectrum disorder

Objective: The objective of this study is to compare the diagnosis of the children and adolescent with PDD diagnose according to DSM-IV-TR who were referred to Dokuz Eylül Medical Faculty Child and Adolescent Psychiatry Department to DSM-5 diagnosis system. Method: In total, 150 children and adolescents between the ages of 3 to 15 with the diagnose of PDD according to DSM-IV-TR who were reffered to Dokuz Eylül University Medical Faculty Children and Adolescent Psychiatry out-patient unit between the dates of February 2014 to November 2014 were included in the study. Detailed information was given to both the cases and their parents about the study and written consent was obtained from each participant. Within the context of the study, symptoms reported by the parents of the children and adolescents diagnosed with Autistic Spectrum Disorder and also the symptoms that were observed in the process of assessment were reviewed by carrying out a detailed psychiatric evaluation by using both DSM-IV-TR and DSM-5 criteria. Data collected from the cases and their parents were recorded in the sociodemographic data form for each case, separately. Clinical severity of the cases' symptoms were determined by using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). Results: The rate of forming a diagnosis with DSM-5 criteria decreased by 19,3% (n=29) compared to using DSM-IV-TR criteria and this finding was statistically significant. Cases with Asperger Disorder and Pervasive Developmental Disorder- None Other Specified (PDD-NOS) were not formally diagnosed when DSM-5 criteria were used. When cases diagnosed and not diagnosed by using DSM-5 criteria were compared by age groups and mean age, a statistically significant difference was found while the comparison of groups by gender did not yield to significant difference. The new B4 criteria which is also a novel difference regarding DSM-5 criteria was the most commonly met criteria among the cases by 83,3%. Total mean scores of Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) scales were found to be much higher in cases who were diagnosed by using DSM-5 criteria. Significant relationship between total CARS and ABC scores and severity levels for DSM-5 Autistic Spectrum Disorder A and B criteria was determined through statistical analyses conducted. Conclusion: Results of this study show that, some of the individuals who had PDD diagnose according to DSM-IV-TR may not get diagnosed according to DSM-5 criterias.