Reassessment of pervasive developmental disorder-‘not otherwise specified cases’ outcomes according to DSM IV-TR criteria

摘要

Objective: Autism Spectrum Disorders (ASD) are developmental disorders characterized by deficits in social relating, communication impairments, and the presence of restricted interests and stereotyped behaviors. The issue of diagnostic stability and course in the field of autism and disorders of this spectrum has become an increasing focus of research. Studies in this field are found inadequate in our country. The purpose of this study is an evaluation 4 years later according to DSM IV-TR criteria of patients who had been diagnosed as PDD-NOS between ages 0-6. Method: In this study, patients between ages 0-6 are included who in the year 2010-2011 had been diagnosed with PDD-NOS by Ege University Disabled Health Committee. Kiddie-Schedule for Affective Disorders and Schizophrenia (SADS) is administered to every participant in the study. All participants are diagnostically reevaluated with a questionnaire form examining Pervasive Developmental Disorders (PDD) diagnosis criteria based upon DSM IV-TR. In addition, Children Autism Rating Scale (CARS) is administered to every participants in the study; Aberrant Behavior Checklist (ABC) was completed with their parents. Results: Parents of 28 out of 150 patients diagnosed by the committee accepted to participate voluntarily in the study and they were reevaluated. Patients of this study were 23 boys and 5 girls. The mean age of the children at the time of first diagnosis was 3.79 years (SD=1.22), and at present 8.18 years (SD=1.80). After reevaluation, 14 of the 28 (50%) children who were initially diagnosed with a PDD-NOS diagnosis retained the same diagnosis, 11 (39.3%) children moved to an AD diagnosis, 1 (3.6%) child moved to an Asperger Disorder diagnosis and 2 (7.1%) children went off the spectrum. In these non-PDD diagnosis children no psychiatric diagnosis is detected. Comorbidity rate was 42.9% of participants according to KSAD-S interview in the reevaluation. In PDD-NOS group comorbid psychiatric disorder rate was found 35.7%, in the AD group the comorbid psychiatric disorder rate was found 54.5%. ADHD and Learning disability were diagnosed by clinical assessment for the case with Asperger Disorder. The mean CARS and ABC scores of the group remaining with PDD-NOS diagnosis were found 23.64 (SD=4.58) and 25.5 (SD=26.97) respectively. The mean CARS and ABC scores of the AD group were found 32.15 (SD=8.13) and 34.4 (SD=22.51) respectively. In the group that left the PDD diagnosis, the mean CARS and ABC scores were found as 18.25 (SD=2.47) and 21 (SD=16.97), respectively. Conclusion: It was observed that 7.1% of patients diagnosed with PDD-NOS under the age of 6 years were found to be off the ASD spectrum after the evaluation performed 4 years after the first diagnosis. 42.9% of the patients moved to another PDD diagnosis. The results of our study and the present literature were found consistent. We consider that it would be convenient to support these findings with other studies in Turkey, by increasing the sample size.