title: Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study.
abstract: OBJECTIVE
  The latest definitions of autism spectrum disorders (ASDs) were specified in DSM-IV-TR in 2000. DSM-5 criteria are planned for 2013. Here, we estimated the prevalence of ASDs and autism according to DSM-IV-TR, clarified confusion concerning diagnostic criteria, and evaluated DSM-5 draft criteria for ASD posted by the American Psychiatry Association (APA) in February 2010.
  
  
  METHODS
  This was an epidemiological study of 5,484 eight-year-old children in Finland, 4,422 (81%) of them rated via the Autism Spectrum Screening Questionnaire by parents and/or teachers, and 110 examined by using a structured interview, semi-structured observation, IQ measurement, school-day observation, and patient records. Diagnoses were assigned according to DSM-IV-TR criteria and DSM-5 draft criteria in children with a full-scale IQ (FSIQ) ≥50. Patient records were evaluated in children with an FSIQ <50 to discover diagnoses of ASDs.
  
  
  RESULTS
  The prevalence of ASDs was 8.4 in 1,000 and that of autism 4.1 in 1,000 according to DSM-IV-TR. Of the subjects with ASDs and autism, 65% and 61% were high-functioning (FSIQ ≥70), respectively. The prevalence of pervasive developmental disorder not otherwise specified was not estimated because of inconsistency in DSM-IV-TR criteria. DSM-5 draft criteria were shown to be less sensitive in regard to identification of subjects with ASDs, particularly those with Asperger's syndrome and some high-functioning subjects with autism.
  
  
  CONCLUSIONS
  DSM-IV-TR helps with the definition of ASDs only up to a point. We suggest modifications to five details of DSM-5 draft criteria posted by the APA in February 2010. Completing revision of DSM criteria for ASDs is a challenging task.
authors.affiliation: Clinic of Child Psychiatry, University and University Hospital of Oulu, Finland. marja-leena.mattila@fimnet.fi
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Mattila
authors.forename: Marko
authors.initials: M
authors.lastname: Kielinen
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Linna
authors.forename: Katja
authors.initials: K
authors.lastname: Jussila
authors.forename: Hanna
authors.initials: H
authors.lastname: Ebeling
authors.forename: Risto
authors.initials: R
authors.lastname: Bloigu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Joseph
authors.forename: Irma
authors.initials: I
authors.lastname: Moilanen
mesh_terms: D020817:Asperger Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005387:Finland; D006801:Humans; D007360:Intelligence; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D015203:Reproducibility of Results; D014175:Translating