DSM-IV or the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) is the Diagnostic Manual for mental disorders. DSM-IV is used by mental health professionals in the USA and other countries. The manual is in the process of undergoing revision and the new version is due out next year. A press release by the American Psychiatric Association has been issued about the possible removal of the diagnosis of Asperger Syndrome in the new version of DSM-IV which may be subsumed under the broader category of Autistic Spectrum Disorders. In the press release, the APA argues that this may improve the sensitivity of the diagnosis and facilitate the design of ‘better treatment interventions’. The APA also state that there are field trials underway to investigate the effects of these changes. The possibility that this diagnostic label is removed raises many questions. Asperger syndrome is characterised by difficulties in social interactions, restricted interests and behaviours and a number of other associations.
Gary McKinnon, the computer programmer who is charged with accessing NASA and United States military computers is a person with a diagnosis of Asperger Syndrome. He is currently facing extradition
charges to the United States to face trial and his case has involved the intercession of leading Asperger Syndrome expert Professor Simon Baron-Cohen as well as other people including leading British politicians. Numerous organisations catering for people with Asperger Syndrome and their carers have developed including the Asperger’s Syndrome Foundation, SACAR and many other smaller local organisations. If these changes pass through then these people may lose their diagnosis. There are other diagnostic systems particularly the World Health Organisation’s International Classification of Disease Version 10 which retain the diagnosis and the use of these alternative diagnostic systems would depend on local circumstances. For instance ICD-10 is more popular in some countries rather than DSM-IV. There are some people for who this diagnosis has formed part of their identity. While diagnostic labels are considered by some people to contribute to stigma, they are essential in helping mental health professionals to work effectively with people to identify the cause of their difficulties and to deliver effective treatments. For people who have received these diagnostic labels they can help to make sense of often confusing and distressing experiences and can also help people to cope with these difficulties. If the diagnostic label is replaced with another diagnosis this could raise questions for people with Asperger Syndrome and their carers. Some people may find this confusing and need more information on why this is happening.
Usually such changes are associated with an impact assessment and it will be interesting to see the advice and support that mental health professionals are given in helping people to make these adjustments.
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