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Autism Spectrum Disorder in DSM and ICD-10

The American Psychiatric Association (APA) released the Diagnostic and Statistical Manual of Mental Disorders, 5th edition — known as the DSM-5 — on 13-May-2013. The 5th edition changed the formal name for "autism" to Autism Spectrum Disorder from the names used in the DSM-IV. At this stage, it is unclear how the changes in the DSM-5 will affect ASD diagnoses.

The table below shows related terms from the DSM-5 (current), the DSM-IV (superceded) and the World Health Organisation's (WHO) ICD-10 ...

In relation to the DSM-IV and the ICD-10, the term, Autism Spectrum Disorders (note the plural) or ASDs, is a collective term for autism-related disorders.
People using this term may or may not include the rarer conditions/disorders listed below. Clinicians in Australia use two references that describe ASD/PDD and its subtypes. The several references are:

  • The Diagnostic and Statistical Manual of Mental Disorders, fifth edition 2013 (known as the DSM-5) is published by the American Psychiatric Association (APA). The text of the DSM-5 section on Autism Spectrum Disorder can be found online at http://www.autismspeaks.org/what-autism/diagnosis/dsm-5-diagnostic-criteria. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, 1994 (known as the DSM-IV) was published by the American Psychiatric Association (APA). There was also a "Text Revision" to this document, usually known as the DSM-IV-TR, published in 2000.
  • The World Health Organisation publishes the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10). The ICD-10 is available online: see http://apps.who.int/classifications/icd10/browse/2010/en#/F80-F89

An ICD-11 may be published in the forseeable future.

The following table shows relationships between clinical terms and their sources.

Pervasive Developmental Disorders
DSM-5 (2013-now) DSM-IV (1994-2013) ICD-10
299.00 Autism Spectrum Disorder 299.00 Autistic Disorder F84.0 Childhood Autism
299.80 Asperger’s Disorder F84.5 Asperger Syndrome
299.80 Pervasive Developmental Disorder not otherwise specified (PDD-NOS)
(including Atypical Autism)
F84.1 Atypical Autism
F84.8 Other pervasive developmental disorders
F84.9 Pervasive developmental disorders, unspecified
F84.4 Overactive disorder associated with mental retardation and stereotyped movements
299.80 Rett’s Disorder F84.2 Rett’s Syndrome
299.10 Childhood Disintegrative Disorder F84.3 Childhood Disintegrative Disorder

The DSM-5 describes three "severity levels" to be associated with a diagnosis of Autism Spctrum Disorder. These are:

  • Level 3 "Requiring very substantial support”
  • Level 2 "Requiring substantial support”
  • Level 1 "Requiring support”

In relation to updating how a person's diagnoses should be described, the DSM-5 say:

Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.

The DSM-5 states categorically, emphatically and repeatedly that “The descriptive severity categories should not be used to determine eligibility for and provision of services; these can only be developed at an individual level and through discussion of personal priorities and targets”.

other terms

The simple term "autism" is not a formal term. It is a vague and imprecise term.

PDD-NOS in the DSM-IV includes F84.1, F84.8 and F84.9 from the ICD-10

The conditions labelled F84.2, F84.3 and F84.4 are considered rare. There is debate as to whether they are part of the Autism Spectrum.

“High-functioning Autism” (HFA) appears to mean Autistic Disorder (F84.0) with an IQ>70. It is not a formal category in any of these classifications.

Rett's Disorder has followed Fragile X into disorders known as genetic disorders.