CDD was removed, along with Rett's Syndrome, from the new DSM (V). Rett's was removed because APA decided it was actually a genetic disorder based on recent research findings. No explanation was given (that I can find) for the removal of CDD. Does anyone know why, or whether it's now elsewhere in the DSM?
"Under the proposed DSM-V revisions, all pervasive developmental disorders, including childhood disintegrative disorder, will be subsumed under the single diagnostic category of autism spectrum disorders (American Psychiatric Association 2011). The rationale for this change of nomenclature is the high degree of the similar clinical features between the disorders and concern for the validity of each of the disorders as separate entities, as it is now thought that the symptoms of the disorders are on a continuum."
http://www.medmerits.com/index.php/article/childhood_disintegrative_disorder/P1
Thank you. I also just found this:
"Autism Spectrum Disorder
Autism spectrum disorder is a new DSM-5 name that reflects a scientific consensus that four previously separate disorders are actually a single condition with different levels of symptom severity in two core domains. ASD now encompasses the previous DSM-IV autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified."
http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf
I think the three specific PDDs that were removed from the DSM-5 were deleted for somewhat different reasons. Rett's Disorder is obviously a valid taxonomic entity, quite distinct from other disorders, so on the face of it this deletion makes little sense. But the homogeneity of the Rett's presentation and the marked neurological abnormalities (such as slowed head growth) strongly suggest that it is a purely neurological disease whose specific causes will be identified in the not-too-distant future. Hence, it belongs more with such disorders as Down's Syndrome or Prader-Willi Syndrome - diagnoses that would have gone on Axis III if we still had Axis III. Asperger's Disorder was less clearly distinct from garden-variety high-functioning autism (HFA). I think the jury's still out on that issue, but there was also another problem. Many children were being diagnosed with Asperger's Disorder (and made eligible for expensive taxpayer-funded treatment) who were really not pervasively disordered. So some Asperger's cases were pretty much HFA, while others would more appropriately be diagnosed with a Specific Developmental Disorder (such as "Nonverbal Learning Disability"). So the DSM-5 removed Asperger's and added the Social Communication Disorder category, with the idea that the Asperger's population would be split accordingly. As for Childhood Disintegrative Disorder ("Heller's Syndrome"), it, too, was poorly differentiated from "standard" autism. It was also extremely rare. In fact, nearly all cases prior to its inclusion in the DSM-IV were diagnosed at one clinic. It just happened that the clinic in question housed some very influential psychiatrists. I suspect that the disorder was quietly swept away to avoid an embarrassing and prolonged professional wrangle.
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