Saturday, December 09, 2006

Autism no more -- the end of a diagnosis

The diagnosis isn't quite dead, but it's in the ICU:
Entrez Nat Neurosci. 2006 Oct;9(10):1218-20. Time to give up on a single explanation for autism. Francesca Happe, Angelica Ronald and Robert Plomin are at the Institute of Psychiatry, Kings College London, De Crispigny Park, London SE5 8AF, UK.

... We argue that there will be no single (genetic or cognitive) cause for the diverse symptoms defining autism. We present recent evidence of behavioral fractionation of social impairment, communication difficulties and rigid and repetitive behaviors. Twin data suggest largely nonoverlapping genes acting on each of these traits. At the cognitive level, too, attempts at a single explanation for the symptoms of autism have failed. Implications for research and treatment are discussed...
A diagnostic concept that doesn't correspond to etiology, manifestation, prognostic course or therapeutic intervention is, clinically speaking, useless. The diagnosis of autism will remain important as a label for obtaining research funding, for creating budgets, and for obtaining resources for care and treatment; but as a clinical concept it's on its last legs. We'll have to come up with new ways to think about a large variety of neurobehavioral disorders. Schizophrenia, as a concept, is in similar shape. Sometime in the next 20 years they'll both join 'dropsy' and 'soldier's heart' in the bin of discarded diagnoses.

This is very good. In science as in books of magical fantasy, power begins by knowing the name of the enemy....

1 comment:

Anonymous said...

What radical thinking! Dropsy and Rickets were terms known and feared by everyone a generation [or two] ago, How refreshing to think that DSM might be overhauled, renovated or rejuvenated to reflect current developments.
Best wishes