![]() ![]() ![]() In some cases, the 2 conditions can be easily recognized, such as in the individual with ASD who articulates social anxiety and fear of negative appraisal (ASD and social anxiety) or the individual with ASD who describes intrusive thoughts about germs and compulsive hand-washing (ASD and obsessive-compulsive disorder ). Much more research is needed to determine how ASD may affect the presentation of co-occurring disorders, especially those with behavioral overlap. Of course, disorders not listed in the table can, and do, co-occur with ASD, especially in the areas of anxiety, mood, learning, sleep, elimination, and food intake. Table 1 lists the disorders in DSM-IV-TR and DSM-5 that specifically name ASD within the criteria, either for differential diagnosis or for guidance about co-occurring diagnoses. The changes in DSM-5 are an important step in reducing this risk in ASD. Furthermore, when co-occurring conditions are not well accounted for in research studies, our ability to detect signal from noise is hampered. 1 Such failure to recognize co-occurring symptoms as separate conditions can restrict the types of interventions made available to patients. When a patient’s presentation is viewed only through the lens of ASD, we run the risk of diagnostic overshadowing or the misattribution of physical or emotional symptoms to the developmental disorder. These revisions may fundamentally change how we conceptualize ASD, because we will be better able to identify co-occurring conditions for research, clinical care, and even insurance coverage. However, in considering the ASD revisions, the changes to diagnoses throughout DSM-5 also warrant discussion, because they give clinicians new tools for diagnosing the co-occurring conditions often seen in ASD. To the Editor: Much attention has been drawn to the changes within autism spectrum disorder (ASD) criteria in DSM-5. Irrespective of the changes proposed by the DSM-5, future research and clinical practice will continue to find ways to meaningfully subtype the ASD.DSM-5 and Autism Spectrum Disorders: The Changes You Haven’ t Heard About Yet Taken together, these findings do not support the conceptualization of AD, AsD and PDDNOS as a single category of ASD. Nine of these concluded that PDDNOS did not differ significantly from AD while 28 reported quantitative and qualitative differences between them. Likewise, 37 studies compared PDDNOS with AD. Of these, 30 studies concluded that AsD and AD were similar conditions while 95 studies found quantitative and qualitative differences between them. In all, 125 studies compared AsD with AD. The purpose of this review is to analyze the basis of this assumption by examining the comparative studies between Asperger’s disorder (AsD) and autistic disorder (AD), and between pervasive developmental disorder not otherwise specified (PDDNOS) and AD. The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) (APA in diagnostic and statistical manual of mental disorders, Author, Washington, 2013) has decided to merge the subtypes of pervasive developmental disorders into a single category of autism spectrum disorder (ASD) on the assumption that they cannot be reliably differentiated from one another. ![]()
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