Psychiatry changes the view of autism and adhd
"Psychiatry's Bible", DSM, has been made about. The old criteria for adhd and autism are about to be replaced by new ones. But what are the differences, and what do they mean to those who already have a diagnosis?
It is not possible to see if anyone has ADHD or autism. Unlike many bodily conditions, you can not take a blood sample to get an answer. In order to diagnose neuropsychiatric disabilities, one looks instead at how an individual behaves and what he / she experiences.
In order for psychiatrists to be able to diagnose, use the Diagnostic and Statistical Manual of Mental Disorders, or DSM. There are all the requirements to be met to get a certain diagnosis.
- It is often called the psychiatric Bible, it is a collection of all psychiatric diagnoses and the criteria required to fulfill the diagnoses. It gives us who work in psychiatry a common language and the opportunity to diagnose the same way.
So says Adam Helles, a psychologist in child and adolescent psychiatry in Gävle, who also researches autism. In his work, he investigates patients and diagnoses those who meet the criteria for, among other things, adhd and autism. The purpose of diagnosing is that people should get the help and support they are entitled to.
In 2013, a new version of the psychiatric Bible came out. It is called DSM-5 and is slow to be incorporated into Swedish care. 2018 is likely to be based solely on the new criteria for diagnostic purposes.
- What will be the biggest differences for autism in the future?
"It's a whole new think. One has gone from four different diagnoses to one single: autism spectrum state, he sums up.
The four previously separate diagnoses were autism, asperger syndrome, disintegrative disorder in children and atypical autism. The fact that they combine are due to the changing state of knowledge as a result of new research.
"The research of the last 10-15 years has shown that with the old criteria we can find those who are within the autism spectrum, but which of the four diagnoses you make is a bit too random to make it happy.
For example, Adam Helles mentions that it has previously been difficult to distinguish between Asperger's syndrome and high-functioning autism. Since the criteria have been so unclear, the choice of diagnosis has occasionally taken place arbitrarily.
"Whether the diagnosis of asperger's syndrome or autism has been diagnosed has not been much to do with the patient, but instead has been about what a particular doctor or psychologist prefers.
So far Adam Helles believes that the changes are good. The four earlier diagnoses have more similarities than differences, and there is therefore no point in disregarding them.
Already the diagnosis remains
As a consequence of the merger, Asperger's syndrome disappears. However, there is nothing to worry about if you already have a diagnosis.
"All the changes concern how to make new diagnoses. People will not get rid of their diagnosis if you already have one, "says Adam Helles.
According to Adam Helles, the change can still affect the one who has already diagnosed, fixed in another way. When the concept of aspergers becomes less common, it can be harder for the group who today identifies the label.
- We are talking little about the change at the social level. It's a big community, aspie world. There is an empowerment movement that emphasizes the right to be in its own way.
He receives Anne Lönmark at the Autism and Aspergers Association.
"There is some concern not to find its context in the new system. Many with Asperger's syndrome identify strongly with the diagnosis, she says.
Difficult to get autism diagnosis
There is another change in the criteria for autism spectrum states in DSM-5 that have been criticized. Getting diagnosed with autism spectrum states is likely to be harder than getting any of the old diagnoses. Most studies indicate that about 10-20% of those who today receive one of the autism diagnoses would end up using the new criteria.
"DSM-5 is diagnosed with those who have difficulty, but if they are mild, it's not safe to fit in, despite the big impact of everyday life," says Adam Helles.
Does it mean that some can end up next to and do not get the help they need?
- Yes. We have not seen the consequences yet, but the risk exists.
Adhd criteria are fine-tuned
Adhd also updates the criteria in DSM-5. However, the differences will be less than for the autism area.
"For adhd, it's not as overwhelming, but rather fine-tuned. The basic criteria are exactly the same, says Adam Helles.
The "pimples" made are primarily intended to simplify diagnosis throughout life. The previous criteria were focused on children.
- The behavioral examples that existed were in the style of having difficulty sitting down, and instead jumping around. That's the way children with ADHD do. For adults, it may be better
