Neuro Developmental Disorders Intro

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Image by jcomp on Freepik

Despite the fact that the term "neurodevelopmental disorders" has a long history, it was not included in prior editions of the ICD or the DSM. The term refers to a group of early-onset disorders that affect both cognitive and social communicative development, are multi-factorial in origin, have significant sex differences with males being more commonly affected than females, and have a chronic course with impairment lasting into adulthood. The term separates these diseases from other more prevalent childhood disorders, such as anxiety and mood disorders, which were assumed to be the result of some form of psychosocial stress and to have a more episodic history. Following extensive research, we divided these disorders into five major categories, each with its unique system:

1. Motor Disorders
2. Communication Disorders
3. Intelectual Developmental Disorders
4. Emotional and Behavioral Disorders
5. Specific Learning Disorder

We started out with the goal of investigating these five main categories and developing a system to investigate them as well as any subcategories that may appear.
Each category covers neurodevelopmental problems that impact coordination, speech, language, and particular academic learning, as well as autism, attention deficit hyperactivity disorder, tics and Tourette syndrome, stereotyped movements, and intellectual disability.

The American Psychiatric Association and the World Health Organization tackled the issue from opposing perspectives, but with the goal of harmonizing. Both systems rely on reliability, validity, and utility.
The DSM is a categorization system that establishes standards for diagnosis and research, as well as a clinical tool and the foundation for remuneration in the United States.
The World Health Organization prioritizes broader utility, and the ICD-11 is meant to be used in clinical, teaching, training, and health statistics not only for mental health specialists, but also for primary care personnel and others in a variety of cultural situations. More controversially, in the Western world, both diagnostic methods have progressed beyond medical categorization and are now used to determine eligibility for both services and benefits.

The relevance of the categorization system to users, i.e. persons with mental, behavioral, and neurodevelopmental disorders, has been acknowledged throughout the present revision of the DSM-IV, and public input has been sought. The DSM-5 recommendations have attracted a great number of favorable and negative remarks, including the opinion that "normalcy" is being medicalized.

What we do know about the pathophysiology of neurodevelopmental, mental, and behavioral disorders points to a complex interaction of genetics and non-genetic risk factors. Diagnostic criteria for mental and behavioral diseases will continue to rely on surface aspects of behavior (i.e. phenomenology) in the absence of biomarkers, however work groups have advocated that diagnoses without a strong scientific foundation be eliminated.

Reference Source:
1. Stein, D.J., Szatmari, P., Gaebel, W. et al. Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Med 18, 21 (2020). https://doi.org/10.1186/s12916-020-1495-2
2. Baird, G.Classification of diseases and the neurodevelopmental disorders: the challenge for DSM-5 and ICD-11. DMCN (2013). https://onlinelibrary.wiley.com/doi/10.1111/dmcn.12087
3. Image by jcomp on Freepik. https://www.freepik.com/free-photo/brain-writes-with-white-chalk-is-hand-draw-concept_6170400.htm#query=brain&position=13&from_view=search&track=sph

Published, Nov 17, 2022

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