Abstract
* Abbreviations: ARND — : alcohol-related neurodevelopmental disorder DSM-5 — : Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition FAS — : fetal alcohol syndrome FASD — : fetal alcohol spectrum disorders IOM — : Institute of Medicine ND-PAE — : neurobehavioral disorder associated with prenatal alcohol exposure PFAS — : partial fetal alcohol syndrome The adverse effects of alcohol on the developing human comprise a continuum of disabilities termed fetal alcohol spectrum disorders (FASD). In the current issue of Pediatrics , Hagan et al1 discuss the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), of the American Psychiatric Association’s suggestion for inclusion of a new mental health diagnosis as part of this continuum; that is, neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE).2 The present commentary addresses the definition of ND-PAE, how it intersects with the existing diagnostic categories of FASD (fetal alcohol syndrome [FAS], partial fetal alcohol syndrome [PFAS], alcohol-related birth defects, and alcohol-related neurodevelopmental disorder [ARND]),3 and the need for ongoing research and development of common terminology for FASD. ND-PAE is listed in DSM-5 as an experimental “Condition for Further Study,” and thus currently cannot be diagnosed. However, the effects of prenatal alcohol exposure are also included under “Other Specified Neurodevelopmental Disorder” (315.8) with a slightly different definition.2 In both cases, this category is intended for use by mental health professionals, including psychiatrists, psychologists, social workers, nurses, and counselors who cannot make a diagnosis using medical codes.4 DSM-5 codes trigger payment for behavioral health services and can help direct referral of … Address correspondence to H. Eugene Hoyme, MD, Genetics and Genomic Medicine, Sanford Health, PO Box 5039, Sioux Falls, SD 57117-5039. E-mail: gene.hoyme{at}sanfordhealth.org
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