CHICAGO — The now familiar term “Asperger’s disorder” is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But “dyslexia” and other learning disorders remain.
The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation’s psychiatrists. Changes were approved Saturday.
Full details of all the revisions will come next May when the American Psychiatric Association’s new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.
This diagnostic guide “defines what constellations of symptoms” doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it “shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care.”
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Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association’s board of trustees.
The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He led the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.
Other changes include:
• A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids’ who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.
• Eliminating the term “gender identity disorder.” It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn’t a disorder and say calling it one is stigmatizing. The term would be replaced with “gender dysphoria,” which means emotional distress over one’s gender.
