Field trial for autistic disorder in DSM-IV

TLDR

The study aimed to develop a DSM‑IV definition of autism by gathering data from 977 patients across multiple sites. Researchers collected diagnostic data from 977 patients at multiple sites using a standardized coding system administered by 125 raters of varying experience. The study found that the DSM‑III‑R definition of autism was overly broad, the ICD‑10 definition best matched clinicians’ diagnoses, and incorporating other disorders into pervasive developmental disorders was justified, leading to DSM‑IV and ICD‑10 definitions that are conceptually identical and more aligned.

Abstract

This project focused on the development of the definition of autism for DSM-IV.Multiple sites were involved in obtaining information regarding 977 patients with the following clinician-assigned diagnoses: autism (N = 454), other pervasive developmental disorders (N = 240), and other disorders (N = 283). A standard coding system was used, and the raters (N = 125) had a range of experience in the diagnosis of autism. Patterns of agreement among existing diagnostic systems were examined, as was the rationale for inclusion of other disorders within the class of pervasive developmental disorders.The DSM-III-R definition of autism was found to be overly broad. The proposed ICD-10 definition most closely approximated the clinicians' diagnoses. Inclusion of other disorders within pervasive developmental disorders appeared justified. Partly on the basis of these data, modifications in the ICD-10 definition were made; this and the DSM-IV definition are conceptually identical.The resulting convergence of the DSM-IV and ICD-10 systems should facilitate both research and clinical service.