New DSM V, Inattentive ADHD, SCT, Asperger's and Tantrums

New DSM V, Inattentive ADHD, SCT, Asperger's and tantrums

The American Psychiatric Association (APA) met this weekend to approve and finalize changes what will become “The Gospel According to the DSM-V”. This will be the new version of the Diagnostic and Statistical Manual of Mental Disorders that mental healthcare workers use to diagnose and treat conditions such as Inattentive ADHD and Sluggish Cognitive Tempo (SCT). The diagnosis and treatment recommendations for the diagnosis of ADHD will not change at all but several conditions that are often mistaken for ADHD or coexist with ADHD will change.

Regular readers of this blog will remember that when the APA first started discussing changes to the DSM IV, the diagnosis of Sluggish Cognitive Tempo (SCT) was being considered for inclusion as a free standing diagnosis. SCT would get an entry all its own, free of the chains that bound it to Predominantly Inattentive ADHD, (ADHD-PI). This did not happen. The APA decided that they did not have enough information about Sluggish Cognitive Tempo to make SCT a separate diagnosis, so for now anyway, if you are sluggish and inattentive, you will be diagnosed as having ADHD-PI.

The changes that were made that affect people with ADHD include a new diagnosis called Disruptive Mood Dysregulation Disorder or DMDD . The symptoms of this disorder include: “severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation, at least three times a week.” 

That sounds an awful lot to me like the description of the outburst that occur every week in many Combined type ADHD families but it is supposed to be the APA’s response to the over diagnosis, in children , of bipolar disorder. I always thought that weekly severe tantrums were a symptom of Oppositional Defiance Disorder and I am not sure how diagnosing fewer kids with bipolar disorder and diagnosing more kids with this new diagnosis helps anything, but no one asked me…

The APA also eliminated the diagnosis of Asperger’s disorder from the DSM V. Now if you have symptoms of Asperger’s you will just be lumped into the Autism Spectrum diagnosis. This may be a good thing for people with ADHD-PI as Asperger’s can be confused with Inattentive ADHD and the new classification may make health care providers less likely to misdiagnose one as the other.