DSM-5 ASD對臺灣自閉症流行病學及遺傳病學研究的影響

DSM-5 on Epidemiological and Genetic Studies of Autism Spectrum Disorder in Taiwan

這篇綜說文章回顧文獻對自閉症的定義的演變。作者首先介紹 Leo Kanner 早期嬰兒自 閉症及 Hans Asperger 自閉症的病徵。然後，他又介紹兒童自閉症在 ICD-9-CM 的分類，廣 泛性發展疾患 (pervasive developmental disorders) 在 DSM-III 及 DSM-III-R 的分類，自閉期疾 患 (autistic disorder) 及亞斯伯格疾患兩種疾患，在 DSM-IV 中，同屬於廣泛性發展疾患； 但是在 DSM-5 中，兩種疾患不再分開，而同屬於自閉病病譜疾患 (autism spectrum disorder, ASD)。跟據這些診斷的變化，作者擔心 DSM-5 ASD 對未來的臺灣自閉症流行病及遺傳病學 研究的影響。總體來說，DSM-5 ASD 可能造成負性的影響比正性的影響更多，未來臺灣的 研究者必須全心的注意 DSM 5-ASD 可能造成的負性的影響。

This overview reviews the evolution of the definition and diagnostic criteria of autism spectrum disorder (ASD). The author starts to introduce the work on early infantile autism by Leo Kanner and the work on autistic psychopathy by Hans Asperger. Then, he describes how infantile autism is defined in ICD-9-CM, and pervasive developmental disorders in DSM-III and DSM-III-R, how autistic disorder and Asperger’s disorder as subtypes of pervasive developmental disorders in DSM-IV, as well as how ASD as a single category is listed in DSM-5. With all those background information, the author warns the impacts of DSM-5 ASD on future studies of ASD epidemiology and genetics in Taiwan. Overall, it seems that the implementation of DSM-5 ASD may cause more negative results than provides positive influences. Investigators of ASD in Taiwan must be mindful of the poten-tially negative impacts caused by the DSM-5ASD.