Psychiatry's "Bible" Gets an Overhaul-LDs

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<p>[Psychiatry's</a> “Bible” Gets an Overhaul: Scientific American](<a href=“http://www.scientificamerican.com/article.cfm?id=redefining-mental-illness]Psychiatry’s”>http://www.scientificamerican.com/article.cfm?id=redefining-mental-illness)</p>

<p>“3.The revised manual will very likely scrap psychiatry staples such as Asperger’s syndrome and paranoid personality disorder.”</p>

<p>"Certain behavioral quirks have long been thought to distinguish Asperger’s syndrome from other autistic disorders. “Aspies,” as people with this affliction sometimes call themselves, tend to develop intense fascination with very specific objects or facts—the wheels of toy cars or the names of constellations—in the absence of a general interest in, say, automotive mechanics or astronomy. Now the diagnosis will disappear, and Aspies may find an important part of their identity stripped away.</p>

<p>Currently Asperger’s is one of five so-called pervasive developmental disorders, along with autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and the lesser-known Rett syndrome and childhood disintegrative disorder (CDD). All these problems are characterized by deficits in communication and social skills as well as by repetitive behaviors. Indeed, the APA has decided that four of the five disorders—autistic disorder, Asperger’s, CDD and PDD-NOS—are so similar that they should all be placed into a new category called autism spectrum disorder (ASD). Psychiatrists using the new DSM will give anyone on the spectrum a diagnosis of ASD, along with a rating of illness severity.</p>

<p>Children whom psychiatrists would previously have diagnosed with CDD fall at the more severe end of the spectrum. They typically experience an almost complete deterioration of social and communication skills starting sometime between the ages of two and 10. Asperger’s patients will land on the milder end. They generally do not show language delays and, in fact, often display excellent verbal skills. Rett syndrome, in which known genetic mutations stunt physical growth, along with language and social skills, is gone from the manual entirely. Ironically, the APA is eliminating it because a genetic test for the condition makes diagnosis so precise and straightforward. For now the DSM prefers to limit itself to a blunter diagnostic measure: behavior."</p>

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<p>As a non-clinical person that makes sense to put these on a spectrum with severe cases at one end and mild cases at the other. I can’t imagine it will change the protocols all that much and perhaps give psychiatrists perhaps more flexibility…but again I’m not a clinician.</p>