DSM panel holds firm on new autism diagnosis, ditches 2 other revisions

A panel of psychiatrists revising the influential Diagnostic and Statistical Manual of Mental Disorders are holding firm to their streamlined diagnosis for autism but are backing off proposals for changes to some others.

How the definitions turn out in the fifth edition of the DSM when it is published next year has huge implications for the pharmaceutical industry, which has reaped huge returns from doctors turning to drugs more often for treatments. Drug treatments for autism are seen to have great potential in the market, for example, so how the manual ends up on that diagnosis is being closely monitored by the industry.

The doctors said evidence did not support creation of the diagnoses "attenuated psychosis syndrome" or "mixed anxiety depressive disorder." The first is supposed to identify anyone at risk of developing psychosis, while the second was seen as a hybrid of anxiety and depression, reports The New York Times.

They also made some changes to the definition of depression so that people experiencing the kind of common sadness anyone might experience after an event such as a death in the family were not diagnosed with a mental condition.

Dr. David J. Kupfer, who is leading the group revising the manual, said there was a decision that some proposed diagnoses needed further study after reviews of field trials on whether different doctors would reach a diagnosis in the same way.

"Our intent for disorders that require more evidence is that they be studied further, and that people work with the criteria," and refine them, said Kupfer who also is a professor of psychiatry at the University of Pittsburgh.

The proposed definition of autism--which eliminates related labels like Asperger's syndrome and "pervasive developmental disorder"--has been hotly debated. In January, Yale University researchers presented evidence that about half of the people with the diagnosis who are considered high-functioning would no longer qualify under the new diagnosis and so lose certain treatment benefits. That was countered, however, this week at the association's annual meeting when new data showed that few children would be affected by the change.

- read the Times story