Skip to main content

Childhood Disintegrative Disorder: Clinical Features and Diagnostic Criteria

Childhood Disintegrative Disorder: Clinical Features and Diagnostic Criteria

Waleed Ahmad
Published online by MRCPsych UK: Tuesday, 03 May 2022


There is a loss of skills in several areas of development and deficits in social, communicative, and behavioural functioning that follow normal development in this condition. Often the condition follows a prodromic period during which children develop obscure symptoms; they become restive, irritable, anxious, and overactive. Impoverishment follows this and then loss of speech and language, accompanied by behavioural disintegration. Sometimes the loss of skills is persistently progressive (especially if there is an underlying progressive neurological condition), but more often, the decline over some months and then a slight improvement. The prognosis is usually abysmal, and it leaves most individuals with severe intellectual disability. There is uncertainty about the extent to which this condition differs from autism. Sometimes, the disorder can be because of some associated encephalopathy, but clinicians should make the diagnosis on the behavioural features. If the condition occurs because of an underlying neurological condition, clinicians should record that separately.

Diagnostic Features

  1. Diagnosis requires a healthy development during the first 2 years of life, followed by a loss of skills; qualitatively, abnormal social functioning accompanies this.
  2. A profound regression of language, level of play, social skills, adaptive behaviours, and bowel, or bladder control are common.
  3. Patients also lose interest in the environment and develop stereotypes, mannerisms, and social, and communication deficits.
  4. Unlike dementia, there is no evidence of organic disease, and the lost skills may recover. Thus, the ICD-10 has classified the syndrome as a pervasive developmental disorder, instead of dementia.1

Inclusions and Exclusions

The ICD-10 includes the following under childhood disintegrative disorder:

1. Symbiotic psychosis
2. Heller disease
3. Disintegrative psychosis
4. Dementia infantilis

However, the following are excluded:

1. Selective mutism
2. Schizophrenia
3. Rett disorder
4. Acquired epileptic aphasia

With autistic disorder, Asperger syndrome, and atypical autism, the DSM-5 and ICD-11 classifications have subsumed it under autism spectrum disorders.2-3

About the Author

Waleed Ahmad, consultant psychiatrist at the Department of Psychiatry, Mercy Teaching Hospital, Peshawar, Faculty member at the Department of Psychiatry and Behavioural Sciences, Peshawar Medical College, Peshawar, 25 000, KP, Pakistan. Email:


Copyright © The Author(s), 2022.


1. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. 10th ed. World Health Organization; 1992.
2. Association AP. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
3. Organization WH. International Classification of Diseases, Eleventh Revision (ICD-11). World Health Organization. Updated February 11, 2022. Accessed April 25, 2022.


Popular posts from this blog

ADVOKATE: A Mnemonic Tool for the Assessment of Eyewitness Evidence

ADVOKATE: A Mnemonic Tool for Assessment of Eyewitness Evidence A tool for assessing eyewitness  ADVOKATE is a tool designed to assess eyewitness evidence and how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologists, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (

ICD-11 Criteria for Anorexia Nervosa (6B80)

ICD-11 Criteria for Anorexia Nervosa (6B80) Anorexia Nervosa is characterised by significantly low body weight for the individual’s height, age and developmental stage that is not due to another health condition or to the unavailability of food. A commonly used threshold is body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under 5th percentile in children and adolescents. Rapid weight loss (e.g. more than 20% of total body weight within 6 months) may replace the low body weight guideline as long as other diagnostic requirements are met. Children and adolescents may exhibit failure to gain weight as expected based on the individual developmental trajectory rather than weight loss. Low body weight is accompanied by a persistent pattern of behaviours to prevent restoration of normal weight, which may include behaviours aimed at reducing energy intake (restricted eating), purging behaviours (e.g. self-induced vomiting, misuse of laxatives), and behaviours aimed at incr

ICD-11 Criteria for Schizophrenia (6A20 )

ICD-11 Criteria for Schizophrenia (6A20 ) Schizophrenia is characterised by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganisation in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one's feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g., behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organisation of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schi