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Autism Spectrum Disorder (ASD) in DSM-5 comprises the former DSM-IV-TR diagnoses of Autistic Disorder, Asperger's Disorder and PDD-nos. The criteria for ASD in DSM-5 were considerably revised from those of ICD-10 and DSM-IV-TR. The present article compares the diagnostic criteria, presents studies on the validity and reliability of ASD, and discusses open questions. It ends with a clinical and research perspective.

Objectives: Asperger's Syndrome is a disorder of uncertain nosological validity, which is difficult to differentiate from high-functioning autism. Even today these disorders are unfortunately diagnosed very late, often in the wake of earlier, different diagnoses. The purpose of this study is to present a screening instrument (MBAS), which is sensitive to these disorders., Methods: The instrument was tested among a total of 91 probands (44 of whom had been diagnosed as autistic, and 47 of whom had been diagnosed with a non-autistic disorder)., Results: The items on the MBAS were of average difficulty; generally, the all item-total correlation was good. The total scale has an internal consistency of Cronbach's alpha = .91 and the convergent validity of the MBAS and the ADI-R reached r = .61 (p = .001). The total score of the questionnaire discriminated highly significantly between the group with autism and that without. At a sensitivity of 95.5% and a specificity of 95.7% the number of misclassifications is low. False negative classifications occurred only in the case of very young children., Conclusions: The MBAS is a reliable and valid instrument for screening and generating tentative diagnoses of high-functioning autism. The questionnaire is well suited for the selection and generation of tentative diagnoses of autism on a high-functioning level.

Objectives: Established scales for the early detection and general diagnostics of autism will be reviewed with a focus on the instruments available in German., Methods: All questionnaires, observation scales and interviews for the assessment of autism and associated conditions found in a search of Medline, PsychInfo, Psyndex and Google up to May 2004 are quoted. Instruments adapted and developed for the German-speaking countries are presented in more depth., Results: An increasing number of reliable national and international scales for the assessment of disorders of the autism spectrum are available. Currently a combination of the Social Communication Questionnaire (SCQ), the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) is regarded as the standard for a psychometrically based diagnosis of autism., Conclusions: For certain diagnostic groups and issues there continues to be a need for German-language instruments. Particularly scales for the assessment of the broader phenotype of autism, as well as instruments that are more sensitive to change would be desirable for outcome measurement and intervention evaluation.

The concept of hebephrenia according to Kleist and Leonhard describes distinct clinical entities with a chronically progressive course leading to residual syndroms with a clear cut symptom constellation which is stable over time. The main symptom is a specific kind of pathological affectivity resulting in a lack of profound future- orientated tension. In six case-reports we illustrate the characteristical clinical picture of the autistic hebephrenia, one of the four subforms of hebephrenic psychoses according to Leonhard. The characteristical clinical syndrom consists of an affective blunting, autistic withdrawal, unfathomable facial expression, unhappy mood and periods of moodiness with aggressive excitement. The concept of hebephrenia according to Kleist and Leonhard presents a promising heuristic attempt for biological-etiological research. In ICD-10 and DSM-IV the usual concept of hebephrenia is a rather vaguely defined nosological category with a polymorphous non-specific symptomatology.

Objectives: This study investigated whether empirically derived dimensions of autistic behavior are consistent with the content-valid construction of the autistic behavior domains according to ICD-10 and DSM-IV (social interaction, communication and repetitive, stereotyped behavior)., Methods: A principal component exploratory factor analysis routine with varimax-rotation and extraction of factors following the Scree criterion was run using data from the Autism Diagnostic Interview-Revised (ADI-R) of N = 262 individuals exhibiting autism or autistic features., Results: A three-factor solution consisting of two socio-communicative and one language dimension and accounting for 46.1% of the total variance was found to best describe the data. These factors yielded only vague correspondence with the idea of behavior domains described in ICD-10 and DSM-IV. In addition, factor loadings of items representing repetitive, stereotyped patterns were generally weak., Conclusions: The factor-analytic approach to autism indicates a conception of the disorder divergent from that defined in the contemporary psychiatric classification systems, especially regarding the area of repetitive, stereotyped behavior.

Since the introduction of a separate diagnosis for Asperger's syndrome in the ICD-10 and DSM-IV classification systems, a controversial debate has continued on whether Asperger's syndrome is a specific, clearly distinguishable disorder within the autistic spectrum or whether it represents a milder phenotypical variation of autism. The effect on the amount of autistic symptoms of the variables language delay and level of intelligence was analyzed within a sample of individuals exhibiting autism diagnosed by standardized methods. Both variables showed a significant effect on the degree of autistic symptoms in that impairments in social interaction were less noticeable. In addition, a subsample of individuals exhibited symptoms assumed to be characteristic for Asperger's syndrome. The findings support the assumption that autism and Asperger's syndrome represent "extreme points" on a scale of severity, which leads to the suggestion that the classification of different subtypes of autism could be abandoned in favor of a dimensional (multiaxial) approach.

Asperger syndrome is an autistic disorder which was first described in 1944 without further acceptance in the literature over almost four decades. Following several publications in the "80's, the disorder became more widely known. Asperger syndrome was introduced into ICD-10 and DSM-IV as a new diagnosis in 1988 and 1994, respectively. Several authors developed own criteria. Until now, some of the diagnostic criteria of Asperger syndrome remain controversial. We present a survey and a comparison of the criteria in the classification of DSM-IV, ICD-10 and of other authors. Six criteria are widely accepted, but there are divergent opinions about the criteria "intelligence" and "speech development".