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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Autism and psychotic features When I look Pervassive Developmental Disorders in DSM 4, it says nothing about the psychotic simptoms. However, I hace some evidents that autism does have something to do with psychotic simptoms. When I look up the DSM 4 criteria for Schizotypal Personality Disorder, it says that condition does not occure exclusively during Pervassive Developmental Disorder. This implies that milder psychotic simptoms, that schizotypals experience, might all be accounted for autism, so autistics don't need additional diagnosis of schizotypal personality disorder. At this point, DSM 4 becames umbiguous: on one hand in the autism section it does not give anyy psychotic simptoms, on the other hand, at schizotypal section it implies that autism associated with psychotic simptoms. Please resolve this umbiguity. I am also wondering why Donna Williams in her "Nobody Nowhere" talks about Willie whom she saw only in darkness and who was there to protect her. Why didn't she receive an additional diagnosis of schizophrenia after she revealed this hallucination in her book? I am afraid this ambiguity will not be resolved by me or any one else until we have a new DSM, the problem with the DSM as with a;ll classifications is that it attempts to put biological phenomena which often merge and blend into each other in distinct boxes.In this case the features exhibited by any one individual may not be easily summarised by a single label so a second label is often used. The disease descriptions try to portray the more typical features of a disorder so rare or exceptional features are not always mentioned. I would use the DSM as a guide not a set of rigid boxes, this is particularly important in psychiatry and developmental disorders where there are no absolute laboratory tests to help in diagnosis, ambiguities like this are the reason we have DSM $ and will eventually have DSM 5 and 6, each will hopefully be an improvement on the last one. As regards the last part of your question I have no way of knowing why Donna Williams did not recieve the additional diagnosis of schizophrenia, perhaps its is because in general things people write in books are not used as evidence to make a diagnosis. |
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