5 ms·

Since when was autism classified as a disease?

dogma1138 7y ago
Since always? It’s a developmental disorder, and a disease is “a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.” Pretty much every medical body would list it under its classification of illnesses. e.g. NHS: https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/autistic-spectrum-disorder-asd https://www.nhsinform.scot/illnesses-and-conditions/brain-ne...
- DoofusOfDeath 7y ago
  Perhaps the GP was referring to the role that social norms play regarding whether some abnormality is considered a disease or not, and the ensuing debates about whether or not is should be.
  - dogma1138 7y ago
    Any abnormality that adversely affects the form or function of the human body that does not stem form physical injury is a disease. The problem here is that most people think that those who suffer from autism are the quirky guy at work who’s good at math while in reality most of them would be in diapers trough adulthood. In reality it is a terrible debilitating disease that enacts a huge toll on both those who suffer from it and their families. I really hope no one would have to live through the fear that they can’t die because no one would be there to provide the life long support their child might need, not to mention having to live with that responsibility for the rest of their natural life.
    - anoncake 7y ago
      The issue is that it's really both. It's kind of pointless to debate the effects of autism when one side is thinking "Light Aspergers" and the other "Adults in diapers".
      - dogma1138 7y ago
        Unlikely, at least not in a clinically useful manner. A disease is a disease, one of the strongest arguments against the "high functioning" part of the autism spectrum these days is that these people don't seem to exhibit much if any of the comorbidity syndromes prevalent to autism especially the physiological one. The lower you go on the spectrum the higher the chances for comorbidity for a lot of other conditions, mitochondrial and metabolic syndrome, fragile x chromosome, gastrointestinal diseases and many many more horrific things. For example the reason why many people who suffer from autism would require diapers after being potty trained isn't because of MR or any other intellectual disability but because they are more likely to suffer from encopresis which leads to fecal leakage. It also doesn't help that the image of autism was changed from kids that would require tremendous support for the rest of their life to SV engineers making 500K a year that can't seem to be able to not be a jerk or are too introverted. As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish. If ASD has a single or a subset of related underlying genetic causes then it's a single disease, and if these causes are present both in high functioning and low functioning autistic individual then it is truly a single condition, however it is still a disease just like relapsing MS is a disease even if it never fully flares out. That said however I have a strong feeling that the more we understand the epidemiology of ASD the more likely we'll find out that it's much more likely a group of distinct diseases with different causes. And some might not even be classified as a condition anymore.
        deleted 7y ago
        [deleted]
        astine 7y ago
        "The lower you go on the spectrum the higher the chances for comorbidity for a lot of other conditions, mitochondrial and metabolic syndrome, fragile x chromosome, gastrointestinal diseases and many many more horrific things." Or the greater the likelihood that the autism symptoms are caused by one of these conditions as opposed to it being a primary condition. Fragile-x in particular is a genetic condition known for its physical and mental effects, much like like prader-willi syndrome or down syndrome. It's just as likely that effects from these conditions are being misdiagnosed as autism. Your post seems confused more generally, though. What clinicians are diagnosing with ASD is a cluster of symptoms, not a specific syndrome. Symptoms can have multiple etiologies and that would still be useful clinically. A cold is treated similarly regardless of the exact viral strain causing the infection. That a particular person doesn't have to deal with anal leakage is not an argument that they don't have a different condition. "As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish." If I was willing to lie to a therapist, I could probably get diagnosed with depression, anxiety, bipolar disorder, or any of a large number of disorders, but the presence of malingering creeps doesn't disprove the existence of those conditions.
    - her_tummy_hurts 7y ago
      The problem is how diverse people with Autism are. So in reality autism is the quirky guy with social problems, those who need life long support, and everything in between.
- dazfuller 7y ago
  With 2 kids and a partner diagnosed as being autistic, it's a massive trigger for me. Seen so many health professionals because of my family, not one has ever referred to it as a disease. Just to elaborate further. Child 1 - ASD/ADHD Child 2 - ASD/SPD possibly PDA Partner - ASD/SPD They're all different and display different characteristics,have differing needs and have different mental health issues. Child 1 is about 2 years behind their peers educationally and socially, Child 2 is on par.
  - wswkb 7y ago
    The fact that it's a massive trigger for someone doesn't mean it's less of a disease. Maybe the problem is the negativity the word "disease" brings, but someone who suffers autism is a diseased person.
    - dazfuller 7y ago
      Or not https://www.nhs.uk/conditions/autism/what-is-autism/ https://www.nhs.uk/conditions/autism/what-is-autism/
hairyhulk 7y ago
Agreed...
snrji 7y ago
Since always. What is it otherwise?
- umvi 7y ago
  There was an HN thread the other day about how some (many?) autistic people don't think there is anything wrong with them and that they wouldn't "cure" themselves even if there were a "cure" because from their point of view there is nothing to cure and they are happy the way they are.
  - dogma1138 7y ago
    Some highly functioning adults which some medical professionals advocate shouldn’t even be on the spectrum might feel like that. Most people on the spectrum will require help to go to the bathroom or complete other basic tasks so them making medical decisions is unlikely. There is now a pretty big concern about the over-diagnosing of ASD especially amongst functioning adults. In many countries you can be diagnosed in a commercial center without even seeing a doctor, it has become almost a business similar to the ADHD “epidemic” of the early 2000’s.
    - nicoburns 7y ago
      So I'd consider myself one of these people. And I think it's really important that people like myself are grouped with those with more severe forms of autism. Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction. It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing. I agree that those with more debilitating forms might want treatment.
      - dogma1138 7y ago
        >I agree that those with more debilitating forms might want treatment. Those are the majority. >So I'd consider myself one of these people. I got myself positively diagnosed also, not autistic in any way, the behaviour therapists that can diagnose anyone in the UK should be thrown out, any diagnosis especially in adulthood that does not involve multiple doctors including neurologists and psychiatrists is not something I take too seriously. >And I think it's really important that people like myself are grouped with those with more severe forms of autism. Why? there is no clinical significance to this. I'm being honest here, from your perspective what is the clinical significance of your diagnosis in general not to mention of being grouped with people who will suffer from fecal leakage all their life? If your diagnosis is not used to treat or manage your condition it is not clinically significant. >Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction. Considering that you are highly unlikely to suffer from any of syndromes that are comorbid to low functioning autistic individuals I would strongly disagree, and I have a strong feeling that once we understand the genetics of this disease better especially in relation to FXS and mitochondrial syndromes I will be right. >It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. The epidemic is about just how many diagnosis centers are popping up targeting adults as a business with little to no oversight. This is really terrifying that we've watered down the diagnosis of autism to a behaviour therapist who had a 6 week course that can diagnose you in a single session. >Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing. No it doesn't in fact it detracts severely from those who actually need help the most, those without a six figure salary. Just look at where the funding and attention goes these days vs 10 or 20 years ago.
daegloe 7y ago
Whether ASD is a disease or illness is still out for debate [0]. What most seem to agree on is that “Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders [1].” Is a disorder a disease? While the terms are often used interchangeably by us laymen, the DSM-5 distinguishes the two [2]. [0] https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201510/is-autism-mental-illness https://www.psychologytoday.com/us/blog/abcs-child-psychiatr... [1] https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat... [2] http://www2.hawaii.edu/~heiby/overheads_classification.html http://www2.hawaii.edu/~heiby/overheads_classification.html
pasiaj 7y ago
The DSM-III, published in 1980, established autism as its own separate diagnosis and described it as a “pervasive developmental disorder” distinct from schizophrenia.
- soup10 7y ago
  The DSM is largely a tool for billing insurance, it has so many different "disorders" listed that everyone falls into at least one category or another at some point in their lives.
  - deleted 7y ago
    [deleted]
- thelasthuman 7y ago
  Wasn't homosexuality still considered a disease in the DSM-III?
  - mftrhu 7y ago
    Almost. It was declassified as a disease by the American Psychiatric Association in 1973 [1] (and by the American Psychological Association in 1975 [2]), and the DSM-III has been the first edition to not include homosexuality. It still contained ego-dystonic homosexuality (TL;DR: "I don't want to be gay") - which was opposed by the APA in 1987 [3] - until 1988, with the publication of the DSM-III-R. [1]: https://www.nytimes.com/1973/12/16/archives/psychiatrists-in-a-shift-declare-homosexuality-no-mental-illness.html https://www.nytimes.com/1973/12/16/archives/psychiatrists-in... [2]: https://www.apa.org/about/policy/discrimination https://www.apa.org/about/policy/discrimination [3]: https://www.apa.org/about/policy/diagnoses-homosexuality-archived https://www.apa.org/about/policy/diagnoses-homosexuality-arc...
checkyoursudo 7y ago
I don't know whether autism should be considered a disease or something else, but having a disease doesn't make a person bad or less valuable. How about we work on understanding and acknowledging that having a disease or mental illness or physical disfigurement or disability is ok, no matter what it is? Maybe I am reading too much into this question. I am sorry if I am. It's a pretty sore subject for me. I'm not trying to offend anyone.
atian 7y ago
When it affects quality of life.

Since always? It’s a developmental disorder, and a disease is “a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.” Pretty much every medical body would list it under its classification of illnesses. e.g. NHS: https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/autistic-spectrum-disorder-asd https://www.nhsinform.scot/illnesses-and-conditions/brain-ne...

DoofusOfDeath 7y ago
Perhaps the GP was referring to the role that social norms play regarding whether some abnormality is considered a disease or not, and the ensuing debates about whether or not is should be.
- dogma1138 7y ago
  Any abnormality that adversely affects the form or function of the human body that does not stem form physical injury is a disease. The problem here is that most people think that those who suffer from autism are the quirky guy at work who’s good at math while in reality most of them would be in diapers trough adulthood. In reality it is a terrible debilitating disease that enacts a huge toll on both those who suffer from it and their families. I really hope no one would have to live through the fear that they can’t die because no one would be there to provide the life long support their child might need, not to mention having to live with that responsibility for the rest of their natural life.
  - anoncake 7y ago
    The issue is that it's really both. It's kind of pointless to debate the effects of autism when one side is thinking "Light Aspergers" and the other "Adults in diapers".
    - dogma1138 7y ago
      Unlikely, at least not in a clinically useful manner. A disease is a disease, one of the strongest arguments against the "high functioning" part of the autism spectrum these days is that these people don't seem to exhibit much if any of the comorbidity syndromes prevalent to autism especially the physiological one. The lower you go on the spectrum the higher the chances for comorbidity for a lot of other conditions, mitochondrial and metabolic syndrome, fragile x chromosome, gastrointestinal diseases and many many more horrific things. For example the reason why many people who suffer from autism would require diapers after being potty trained isn't because of MR or any other intellectual disability but because they are more likely to suffer from encopresis which leads to fecal leakage. It also doesn't help that the image of autism was changed from kids that would require tremendous support for the rest of their life to SV engineers making 500K a year that can't seem to be able to not be a jerk or are too introverted. As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish. If ASD has a single or a subset of related underlying genetic causes then it's a single disease, and if these causes are present both in high functioning and low functioning autistic individual then it is truly a single condition, however it is still a disease just like relapsing MS is a disease even if it never fully flares out. That said however I have a strong feeling that the more we understand the epidemiology of ASD the more likely we'll find out that it's much more likely a group of distinct diseases with different causes. And some might not even be classified as a condition anymore.
      - deleted 7y ago
        [deleted]
      - astine 7y ago
        "The lower you go on the spectrum the higher the chances for comorbidity for a lot of other conditions, mitochondrial and metabolic syndrome, fragile x chromosome, gastrointestinal diseases and many many more horrific things." Or the greater the likelihood that the autism symptoms are caused by one of these conditions as opposed to it being a primary condition. Fragile-x in particular is a genetic condition known for its physical and mental effects, much like like prader-willi syndrome or down syndrome. It's just as likely that effects from these conditions are being misdiagnosed as autism. Your post seems confused more generally, though. What clinicians are diagnosing with ASD is a cluster of symptoms, not a specific syndrome. Symptoms can have multiple etiologies and that would still be useful clinically. A cold is treated similarly regardless of the exact viral strain causing the infection. That a particular person doesn't have to deal with anal leakage is not an argument that they don't have a different condition. "As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish." If I was willing to lie to a therapist, I could probably get diagnosed with depression, anxiety, bipolar disorder, or any of a large number of disorders, but the presence of malingering creeps doesn't disprove the existence of those conditions.
  - her_tummy_hurts 7y ago
    The problem is how diverse people with Autism are. So in reality autism is the quirky guy with social problems, those who need life long support, and everything in between.
dazfuller 7y ago
With 2 kids and a partner diagnosed as being autistic, it's a massive trigger for me. Seen so many health professionals because of my family, not one has ever referred to it as a disease. Just to elaborate further. Child 1 - ASD/ADHD Child 2 - ASD/SPD possibly PDA Partner - ASD/SPD They're all different and display different characteristics,have differing needs and have different mental health issues. Child 1 is about 2 years behind their peers educationally and socially, Child 2 is on par.
- wswkb 7y ago
  The fact that it's a massive trigger for someone doesn't mean it's less of a disease. Maybe the problem is the negativity the word "disease" brings, but someone who suffers autism is a diseased person.
  - dazfuller 7y ago
    Or not https://www.nhs.uk/conditions/autism/what-is-autism/ https://www.nhs.uk/conditions/autism/what-is-autism/

hairyhulk 7y ago

Agreed...

snrji 7y ago

Since always. What is it otherwise?

umvi 7y ago
There was an HN thread the other day about how some (many?) autistic people don't think there is anything wrong with them and that they wouldn't "cure" themselves even if there were a "cure" because from their point of view there is nothing to cure and they are happy the way they are.
- dogma1138 7y ago
  Some highly functioning adults which some medical professionals advocate shouldn’t even be on the spectrum might feel like that. Most people on the spectrum will require help to go to the bathroom or complete other basic tasks so them making medical decisions is unlikely. There is now a pretty big concern about the over-diagnosing of ASD especially amongst functioning adults. In many countries you can be diagnosed in a commercial center without even seeing a doctor, it has become almost a business similar to the ADHD “epidemic” of the early 2000’s.
  - nicoburns 7y ago
    So I'd consider myself one of these people. And I think it's really important that people like myself are grouped with those with more severe forms of autism. Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction. It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing. I agree that those with more debilitating forms might want treatment.
    - dogma1138 7y ago
      >I agree that those with more debilitating forms might want treatment. Those are the majority. >So I'd consider myself one of these people. I got myself positively diagnosed also, not autistic in any way, the behaviour therapists that can diagnose anyone in the UK should be thrown out, any diagnosis especially in adulthood that does not involve multiple doctors including neurologists and psychiatrists is not something I take too seriously. >And I think it's really important that people like myself are grouped with those with more severe forms of autism. Why? there is no clinical significance to this. I'm being honest here, from your perspective what is the clinical significance of your diagnosis in general not to mention of being grouped with people who will suffer from fecal leakage all their life? If your diagnosis is not used to treat or manage your condition it is not clinically significant. >Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction. Considering that you are highly unlikely to suffer from any of syndromes that are comorbid to low functioning autistic individuals I would strongly disagree, and I have a strong feeling that once we understand the genetics of this disease better especially in relation to FXS and mitochondrial syndromes I will be right. >It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. The epidemic is about just how many diagnosis centers are popping up targeting adults as a business with little to no oversight. This is really terrifying that we've watered down the diagnosis of autism to a behaviour therapist who had a 6 week course that can diagnose you in a single session. >Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing. No it doesn't in fact it detracts severely from those who actually need help the most, those without a six figure salary. Just look at where the funding and attention goes these days vs 10 or 20 years ago.

daegloe 7y ago

Whether ASD is a disease or illness is still out for debate [0]. What most seem to agree on is that “Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders [1].” Is a disorder a disease? While the terms are often used interchangeably by us laymen, the DSM-5 distinguishes the two [2]. [0] https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201510/is-autism-mental-illness https://www.psychologytoday.com/us/blog/abcs-child-psychiatr... [1] https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat... [2] http://www2.hawaii.edu/~heiby/overheads_classification.html http://www2.hawaii.edu/~heiby/overheads_classification.html

pasiaj 7y ago

The DSM-III, published in 1980, established autism as its own separate diagnosis and described it as a “pervasive developmental disorder” distinct from schizophrenia.

soup10 7y ago
The DSM is largely a tool for billing insurance, it has so many different "disorders" listed that everyone falls into at least one category or another at some point in their lives.
- deleted 7y ago
  [deleted]
thelasthuman 7y ago
Wasn't homosexuality still considered a disease in the DSM-III?
- mftrhu 7y ago
  Almost. It was declassified as a disease by the American Psychiatric Association in 1973 [1] (and by the American Psychological Association in 1975 [2]), and the DSM-III has been the first edition to not include homosexuality. It still contained ego-dystonic homosexuality (TL;DR: "I don't want to be gay") - which was opposed by the APA in 1987 [3] - until 1988, with the publication of the DSM-III-R. [1]: https://www.nytimes.com/1973/12/16/archives/psychiatrists-in-a-shift-declare-homosexuality-no-mental-illness.html https://www.nytimes.com/1973/12/16/archives/psychiatrists-in... [2]: https://www.apa.org/about/policy/discrimination https://www.apa.org/about/policy/discrimination [3]: https://www.apa.org/about/policy/diagnoses-homosexuality-archived https://www.apa.org/about/policy/diagnoses-homosexuality-arc...

checkyoursudo 7y ago

I don't know whether autism should be considered a disease or something else, but having a disease doesn't make a person bad or less valuable. How about we work on understanding and acknowledging that having a disease or mental illness or physical disfigurement or disability is ok, no matter what it is? Maybe I am reading too much into this question. I am sorry if I am. It's a pretty sore subject for me. I'm not trying to offend anyone.

atian 7y ago

When it affects quality of life.