![]() In an effort to reflect what has been learned through research and practice since that time, the DSM-5 released in 2013 removed the PDD category and the accompanying subtypes (Autistic Disorder, Asperger Disorder, Childhood Disintegrative Disorder and Pervasive Developmental Disorder – Not Otherwise Specified) with a single disorder, Autism Spectrum Disorder (ASD). Starting with the DSM-III in 1980, autism was categorized as a Pervasive Developmental Disorders (PDD). In this statement, the IACC describes a range of research, practice, and policy implications that arise as a result of the changes in the DSM criteria which deserve consideration as the DSM-5 is implemented in research, clinical, and educational settings. Any revision of the diagnostic criteria must be made with great care so as to not have the unintended consequence of reducing critical services aimed at improving the ability of persons with autism. ![]() ![]() 1, 2 Although the DSM-5 diagnostic criteria are intended primarily for use by clinicians and researchers in their diagnostic assessments, the IACC is aware that it is important to also remember that these the criteria also have a direct impact on people who have the disorders and their families, and their ability to assess symptoms and obtain services that can help them optimize their health, well-being and quality of life. The DSM-5 criteria were published in May 2013. It was the goal of the Neurodevelopmental (ND) Workgroup for the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to meet these standards. The committee recognizes the need for diagnostic criteria for ASD that reflect current scientific knowledge and progress and define the wide range of symptom expression associated with this disorder. The Interagency Autism Coordinating Committee (IACC) is a Federal advisory committee, composed of Federal and public members, that coordinates all efforts within the Department of Health and Human Services (HHS) concerning autism spectrum disorder (ASD). Much remains to be learned about the DSM-5 MDD specifiers in the general population.IACC Statement Regarding Scientific, Practice and Policy Implications of Changes in the Diagnostic Criteria for Autism Spectrum Disorder While most cases received some treatment, a substantial minority did not. Controlling for severity, both specifiers were associated with early onset, poor course and functioning, and suicidality.Īmong US adults, DSM-5 MDD is highly prevalent, comorbid, and disabling. The anxious/distressed specifier characterized 74.6% of MDD cases, and the mixed-features specifier characterized 15.5%. Among 12.9% of those with lifetime MDD, all episodes occurred just after the death of someone close and lasted less than 2 months. Functioning among those with severe MDD was approximately 1 SD below the national mean. Almost 70% with lifetime MDD had some type of treatment. Most lifetime MDD cases were moderate (39.7%) or severe (49.5%). Associations of MDD with substance use disorders ranged from an aOR of 1.8 (95% CI, 1.63-2.01) for alcohol to an aOR of 3.0 (95% CI, 2.57-3.55) for any drug. Associations of MDD with psychiatric disorders ranged from an aOR of 2.1 (95% CI, 1.84-2.35) for specific phobia to an aOR of 5.7 (95% CI, 4.98-6.50) for generalized anxiety disorder. Of the 36 309 adult participants in NESARC-III, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders. Prevalence of DSM-5 MDD and the DSM-5 specifiers. Data were collected from April 2012 to June 2013 and were analyzed in 2016-2017. In-person interviews with a representative sample of US noninstitutionalized civilian adults (≥18 years) (n = 36 309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). ![]() To present current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 MDD and initial information on the prevalence, severity, and treatment of DSM-5 MDD severity, anxious/distressed specifier, and mixed-features specifier, as well as cases that would have been characterized as bereavement in DSM-IV. No US national data are available on the prevalence and correlates of DSM-5-defined major depressive disorder (MDD) or on MDD specifiers as defined in DSM-5. ![]()
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